Provider Demographics
NPI:1154319846
Name:FRAZIER, SUZANNE MAUREEN (DC)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:MAUREEN
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-5901
Mailing Address - Country:US
Mailing Address - Phone:619-299-5600
Mailing Address - Fax:619-299-1606
Practice Address - Street 1:2911 4TH AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5901
Practice Address - Country:US
Practice Address - Phone:619-299-5600
Practice Address - Fax:619-299-1606
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22543111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor