Provider Demographics
NPI:1497926182
Name:FRIZZELL, SCOTT LEWIS (DC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:LEWIS
Last Name:FRIZZELL
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 1:408 S MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-3183
Mailing Address - Country:US
Mailing Address - Phone:817-453-9797
Mailing Address - Fax:817-453-9780
Practice Address - Street 1:1804 OWEN CT SUITE 102
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063
Practice Address - Country:US
Practice Address - Phone:817-453-9797
Practice Address - Fax:817-453-9780
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9265111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor