Provider Demographics
NPI:1346469871
Name:FROST, STANLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:
Last Name:FROST
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:PO BOX 6588
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29260-6588
Mailing Address - Country:US
Mailing Address - Phone:803-765-1516
Mailing Address - Fax:803-765-1770
Practice Address - Street 1:1713 TAYLOR ST
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3400
Practice Address - Country:US
Practice Address - Phone:803-765-1516
Practice Address - Fax:803-765-1770
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC839111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor