MEDICARE: DR. BRIAN CHARLES FROEHLY 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	3439	SC
2	111N00000X	Chiropractor	DC009893	PA

General Provider Information

NPI Number	:	1871750430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN CHARLES FROEHLY D.C.

Provider Business Mailing Address
First Line	:	679 ORANGEBURG RD
Second Line	:	UNIT A
City	:	SUMMERVILLE
State	:	SC
Zip	:	29483-9038
Country	:	US
Telephone Number	:	843-832-4499
Fax Number	:	843-832-4978

Provider Business Practice Location Address
First Line	:	679 ORANGEBURG RD
Second Line	:	UNIT A
City	:	SUMMERVILLE
State	:	SC
Zip	:	29483-9038
Country	:	US
Telephone Number	:	843-832-4499
Fax Number	:	843-832-4978

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

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	10/25/2019

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