Provider Demographics
NPI:1770704157
Name:FRAZIER, TROY D (DC)
Entity type:Individual
Prefix:DR
First Name:TROY
Middle Name:D
Last Name:FRAZIER
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 1:193 E 860 S
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-5012
Mailing Address - Country:US
Mailing Address - Phone:801-221-1151
Mailing Address - Fax:801-221-1181
Practice Address - Street 1:193 E 860 S
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-5012
Practice Address - Country:US
Practice Address - Phone:801-221-1151
Practice Address - Fax:801-221-1181
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT364214-1202111N00000X, 111NI0900X, 111NR0400X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NI0900XChiropractic ProvidersChiropractorInternist
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitation
Not Answered111NS0005XChiropractic ProvidersChiropractorSports Physician