Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | X010284 | NY |
N | 111NR0200X | Radiology | X010284 | NY |
N | 213ER0200X | Radiology | X010284 | NY |
N | 111NR0400X | Rehabilitation Chiropractor | X010284 | NY |
Y | 111NS0005X | Chiropractic Sports Physician | X010284 | NY |
NPI | 1366539322 |
---|---|
Provider Name | Steven Max Froeschl |
First Address | Dunnellon, FL 34433-4734 |
Second Address | Dunnellon, FL 34433-4734 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2006 |
Last Update Date | 05/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V03321 | (02) | NY |