Provider Demographics
NPI:1528015997
Name:FROEHLE, RICHARD C (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:C
Last Name:FROEHLE
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 1:550 SNELLING AVE S
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-1564
Mailing Address - Country:US
Mailing Address - Phone:651-698-6803
Mailing Address - Fax:651-698-0445
Practice Address - Street 1:550 SNELLING AVE S
Practice Address - Street 2:SUITE 203
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-1564
Practice Address - Country:US
Practice Address - Phone:651-698-6803
Practice Address - Fax:651-698-0445
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN016327900Medicaid
MN016327900Medicaid
MN350002357Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER