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General NPI Number Information
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NPI Number | 1245227511
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Entity Type | Individual
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Provider Name | EDWARD MARTIN FRATTINI DC
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Gender | Male
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 11/30/2010
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Provider Practice Location Address
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Address Line | 22701 GREATER MACK AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-2007
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Country | US
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Telephone | 586-777-6056
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Fax | 585-775-7246
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Provider Business Mailing Address
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Address Line | 22701 GREATER MACK AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-2007
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Country | US
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Telephone | 586-777-6056
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Fax | 585-775-7246
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301004723
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License Number State | MI
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