Provider Demographics
NPI:1922125525
Name:FROST, DAVID R (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:FROST
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PONDVIEW PL
Mailing Address - Street 2:
Mailing Address - City:TYNGSBORO
Mailing Address - State:MA
Mailing Address - Zip Code:01879-1068
Mailing Address - Country:US
Mailing Address - Phone:978-649-1800
Mailing Address - Fax:978-649-1810
Practice Address - Street 1:4 PONDVIEW PL
Practice Address - Street 2:
Practice Address - City:TYNGSBORO
Practice Address - State:MA
Practice Address - Zip Code:01879-1068
Practice Address - Country:US
Practice Address - Phone:978-649-1800
Practice Address - Fax:978-649-1810
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2583111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA411613OtherTUFTS
CT50Y242600MA01OtherANTHEM CT
MA6370806OtherCIGNA
MA2594578OtherAETNA
NH05Y0004118MA02OtherANTHEM NH
MA44-02723OtherUNITED
MAY36795OtherBLUECROSSBLUESHEILD OF MA
MAAA28779OtherHARVARD PILGRIM
MAY36795OtherBLUECROSSBLUESHEILD OF MA