MEDICARE: ALEXANDRA PATRICIA FROST MSPO, CO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Z00000X	Orthotist

General Provider Information

NPI Number	:	1104328368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA PATRICIA FROST MSPO, CO

Provider Business Mailing Address
First Line	:	3031 NEW BERN AVE STE 102
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-2989
Country	:	US
Telephone Number	:	919-231-3132
Fax Number	:

Provider Business Practice Location Address
First Line	:	3031 NEW BERN AVE STE 102
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-2989
Country	:	US
Telephone Number	:	919-231-3132
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2018
Last Update Date	:	03/05/2018

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