Provider Demographics
NPI:1063559128
Name:FRAZHO, SAUNDRA L (DC)
Entity type:Individual
Prefix:DR
First Name:SAUNDRA
Middle Name:L
Last Name:FRAZHO
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 1:4942 N ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48306-1416
Mailing Address - Country:US
Mailing Address - Phone:248-754-1777
Mailing Address - Fax:
Practice Address - Street 1:4942 N ADAMS RD
Practice Address - Street 2:
Practice Address - City:OAKLAND TWP
Practice Address - State:MI
Practice Address - Zip Code:48306-1416
Practice Address - Country:US
Practice Address - Phone:248-754-1777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISF007103111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION27650Medicare ID - Type UnspecifiedMEDICARE ID
MIU76381Medicare UPIN