Provider Demographics
NPI:1629200555
Name:FRISCH, CHAD DONALD (DC)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:DONALD
Last Name:FRISCH
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 1:111 CLEBOURNE ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-1758
Mailing Address - Country:US
Mailing Address - Phone:386-871-4451
Mailing Address - Fax:
Practice Address - Street 1:111 CLEBOURNE ST
Practice Address - Street 2:SUITE 120
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-1758
Practice Address - Country:US
Practice Address - Phone:386-871-4451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3492111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor