Provider Demographics
NPI:1598117087
Name:FROSETH, LACINDA L (DC)
Entity Type:Individual
Prefix:
First Name:LACINDA
Middle Name:L
Last Name:FROSETH
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 1:3324 E RAY RD
Mailing Address - Street 2:UNIT 997
Mailing Address - City:HIGLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85236-4605
Mailing Address - Country:US
Mailing Address - Phone:480-639-8108
Mailing Address - Fax:480-641-9743
Practice Address - Street 1:1145 S POWER RD
Practice Address - Street 2:SUITE 104
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-5293
Practice Address - Country:US
Practice Address - Phone:480-639-8108
Practice Address - Fax:480-641-9743
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3841111N00000X
AZ178171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist