Provider Demographics
NPI:1780632232
Name:FROGLEY HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:FROGLEY HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CORY
Authorized Official - Middle Name:M
Authorized Official - Last Name:FROGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-292-9355
Mailing Address - Street 1:135 SOUTH 500 WEST
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010
Mailing Address - Country:US
Mailing Address - Phone:801-292-9355
Mailing Address - Fax:801-296-8050
Practice Address - Street 1:135 SOUTH 500 WEST
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010
Practice Address - Country:US
Practice Address - Phone:801-292-9355
Practice Address - Fax:801-296-8050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT272983-1202111N00000X
UT4828483-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1780632232OtherGROUP NPI #
UT4828483-1202OtherDR. CORY STATE LICENSE #
UT870395551005Medicaid
UT0272983-1202OtherDR. BLACK STATE LICENSE
UT1033168372OtherDR. CORYS NPI #
UT1033168372OtherDR. CORY NPI #
UT4828483120001OtherDR. CORY BCBS #
UT482848312001Medicaid
UT02729831201001OtherDR. BLACK BCBS
UT1699725747OtherDR. BLACK NPI #
UT1033168372OtherDR. CORY NPI #
UT4828483120001OtherDR. CORY BCBS #
UT482848312001Medicaid