Provider Demographics
NPI:1003845397
Name:FRISCH, TODD T (DC)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:T
Last Name:FRISCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 BAXTER RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-7032
Mailing Address - Country:US
Mailing Address - Phone:636-207-6600
Mailing Address - Fax:636-207-6631
Practice Address - Street 1:510 BAXTER RD
Practice Address - Street 2:SUITE 8
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-7032
Practice Address - Country:US
Practice Address - Phone:636-207-6600
Practice Address - Fax:636-207-6631
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004519111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO431324917OtherFEDERALIDNUMBER