Provider Demographics
NPI:1851468326
Name:FRASER, MARION M (DC)
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:M
Last Name:FRASER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MARION
Other - Middle Name:
Other - Last Name:MINKWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VT
Mailing Address - Zip Code:05454-0002
Mailing Address - Country:US
Mailing Address - Phone:802-825-6068
Mailing Address - Fax:802-825-6068
Practice Address - Street 1:21 CARMICHAEL ST STE 104
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-3186
Practice Address - Country:US
Practice Address - Phone:802-825-6068
Practice Address - Fax:802-825-6068
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0060079970111N00000X, 111N00000X
NYX001718-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1019788Medicaid