MEDICARE: DR. WILLIAM CARL FRISK D.C.

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	111N00000X	Chiropractor	1086	LA

General Provider Information

NPI Number	:	1578687869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM CARL FRISK D.C.

Provider Business Mailing Address
First Line	:	2159 AIRLINE DR
Second Line	:	SUITE #300
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-3197
Country	:	US
Telephone Number	:	318-746-2225
Fax Number	:	318-746-2225

Provider Business Practice Location Address
First Line	:	2159 AIRLINE DR
Second Line	:	SUITE #300
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-3197
Country	:	US
Telephone Number	:	318-746-2225
Fax Number	:	318-746-2225

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

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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