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General NPI Number Information
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NPI Number | 1609381078
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Entity Type | Individual
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Provider Name | AMANDA FROTSCHER
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Gender | Female
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Dates
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Enumeration Date | 12/07/2017
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Last Update Date | 01/14/2019
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Provider Practice Location Address
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Address Line | 70 E LAKE ST STE 630
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City | CHICAGO
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State | IL
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Zip | 60601-5961
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Country | US
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Telephone | 770-312-5347
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Fax |
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Provider Business Mailing Address
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Address Line | 3110 W WALTON ST APT 3A
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City | CHICAGO
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State | IL
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Zip | 60622-4346
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Country | US
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Telephone |
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Fax |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 227017904
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 198001443
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License Number State | IL
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