Provider Demographics
NPI:1407178502
Name:SPINEBODYSPIRIT PLLC
Entity Type:Organization
Organization Name:SPINEBODYSPIRIT PLLC
Other - Org Name:SPINEBODYSPIRIT PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER, DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:DR ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAZER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-616-1602
Mailing Address - Street 1:88 INVERNESS CIR E UNIT I108
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-5515
Mailing Address - Country:US
Mailing Address - Phone:602-616-1602
Mailing Address - Fax:
Practice Address - Street 1:88 INVERNESS CIRCLE E UNITI108
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5505
Practice Address - Country:US
Practice Address - Phone:602-616-1602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1039111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty