Provider Demographics
NPI:1720260987
Name:FRISBY, JED (DC)
Entity Type:Individual
Prefix:
First Name:JED
Middle Name:
Last Name:FRISBY
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 1:431 E HILLSBORO ST
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-7303
Mailing Address - Country:US
Mailing Address - Phone:870-918-0153
Mailing Address - Fax:870-862-2116
Practice Address - Street 1:431 E HILLSBORO ST
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-7303
Practice Address - Country:US
Practice Address - Phone:870-918-0153
Practice Address - Fax:870-862-2116
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1703111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor