MEDICARE: CHRISTOPHER A FRAZIER MSW

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	1041C0700X	Clinical Social Worker	10776882-3501	UT

General Provider Information

NPI Number	:	1821118571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER A FRAZIER MSW

Provider Business Mailing Address
First Line	:	2058 S 1425 W
Second Line	:
City	:	WOODS CROSS
State	:	UT
Zip	:	84087
Country	:	US
Telephone Number	:	928-243-6430
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 E NORTH TEMPLE, COB- ROOM 825
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84150
Country	:	US
Telephone Number	:	928-243-3388
Fax Number	:

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	02/24/2020

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