Provider Demographics
NPI:1639161565
Name:FROGLEY, CHRIS JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:JAMES
Last Name:FROGLEY
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 1:275 BESSIE LN
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:UT
Mailing Address - Zip Code:84332-9107
Mailing Address - Country:US
Mailing Address - Phone:435-753-8898
Mailing Address - Fax:435-753-8898
Practice Address - Street 1:275 BESSIE LN
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332-9107
Practice Address - Country:US
Practice Address - Phone:435-753-8898
Practice Address - Fax:435-753-8898
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04844111N00000X
UT6193648-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0247031Medicaid
T01408Medicare UPIN
IA0247031Medicaid