Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 1175 | NE |
NPI | 1124616644 |
---|---|
Provider Name | Dr. Cynthia Frazier |
First Address | Omaha, NE 68132 |
Second Address | Omaha, NE 68132 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2021 |
Last Update Date | 10/01/2021 |