Provider Demographics
NPI:1265449425
Name:FROSCH, BETH STACY (DC)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:STACY
Last Name:FROSCH
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 1:112 S FEDERAL HWY STE 2
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-4939
Mailing Address - Country:US
Mailing Address - Phone:561-731-0041
Mailing Address - Fax:
Practice Address - Street 1:112 S FEDERAL HWY STE 2
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-4939
Practice Address - Country:US
Practice Address - Phone:561-731-0041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCHOOO6480111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22887Medicare ID - Type Unspecified