Provider Demographics
NPI:1841395571
Name:FRISCHMAN, DAVID LEE (DC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LEE
Last Name:FRISCHMAN
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 1:508 N WABASH ST
Mailing Address - Street 2:
Mailing Address - City:WABASH
Mailing Address - State:IN
Mailing Address - Zip Code:46992
Mailing Address - Country:US
Mailing Address - Phone:260-563-8476
Mailing Address - Fax:260-563-8477
Practice Address - Street 1:508 N WABASH ST
Practice Address - Street 2:
Practice Address - City:WABASH
Practice Address - State:IN
Practice Address - Zip Code:46992
Practice Address - Country:US
Practice Address - Phone:260-563-8476
Practice Address - Fax:260-563-8477
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000788A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T35118Medicare UPIN
861250BMedicare ID - Type Unspecified