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General NPI Number Information
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NPI Number | 1780057778
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Entity Type | Individual
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Provider Name | JAMES RUSSELL FRASER III D.C
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Gender | Male
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Dates
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Enumeration Date | 11/12/2015
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 341 MARKET ST
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City | BASALT
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State | CO
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Zip | 81621-7409
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Country | US
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Telephone | 970-924-1015
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Fax |
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Provider Business Mailing Address
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Address Line | 67 WIDGET ST UNIT 714
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City | BASALT
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State | CO
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Zip | 81621-6705
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Country | US
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Telephone | 970-924-1015
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH11712
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHR.0008508
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License Number State | CO
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