Provider Demographics
NPI:1689323198
Name:FRASCONE, ALEK THOMAS (DPM)
Entity Type:Individual
Prefix:
First Name:ALEK
Middle Name:THOMAS
Last Name:FRASCONE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22201 MOROSS RD STE 250
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2175
Mailing Address - Country:US
Mailing Address - Phone:313-343-3423
Mailing Address - Fax:313-343-3401
Practice Address - Street 1:22201 MOROSS RD STE 250
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236-2175
Practice Address - Country:US
Practice Address - Phone:313-343-3423
Practice Address - Fax:313-343-3401
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program