Provider Demographics
NPI:1114265600
Name:FRACH CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:FRACH CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FRACH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-786-5585
Mailing Address - Street 1:13352 ABERDEEN ST. NE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HAM LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55304-6877
Mailing Address - Country:US
Mailing Address - Phone:763-786-5585
Mailing Address - Fax:763-786-1003
Practice Address - Street 1:13352 ABERDEEN ST. NE
Practice Address - Street 2:SUITE A
Practice Address - City:HAM LAKE
Practice Address - State:MN
Practice Address - Zip Code:55304-6877
Practice Address - Country:US
Practice Address - Phone:763-786-5585
Practice Address - Fax:763-786-1003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-18
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN636087900020111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty