Provider Demographics
NPI:1255455531
Name:FROEHLICH, PATRICK (DC)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:FROEHLICH
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 1:8201 GOLF COURSE RD NW STE C2A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-5805
Mailing Address - Country:US
Mailing Address - Phone:505-792-3311
Mailing Address - Fax:505-792-3314
Practice Address - Street 1:8201 GOLF COURSE RD NW STE C2A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-5805
Practice Address - Country:US
Practice Address - Phone:505-792-3311
Practice Address - Fax:505-792-3314
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1572111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM01KJ65OtherBCBS
NMNM01KJ65OtherBCBS
NMU94540Medicare UPIN