Provider Demographics
NPI:1972851152
Name:FRAZIER, TIMIKA LASHAUN (DC)
Entity Type:Individual
Prefix:DR
First Name:TIMIKA
Middle Name:LASHAUN
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4377 REDWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39212-3636
Mailing Address - Country:US
Mailing Address - Phone:601-291-2597
Mailing Address - Fax:
Practice Address - Street 1:1712 PENNY LN SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-4434
Practice Address - Country:US
Practice Address - Phone:601-291-2597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-20
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1344111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor