Provider Demographics
NPI:1154565356
Name:FRAWLEY, MARK (DC)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:FRAWLEY
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 1:1029 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:COOPERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18036-9702
Mailing Address - Country:US
Mailing Address - Phone:610-967-3951
Mailing Address - Fax:
Practice Address - Street 1:1029 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:COOPERSBURG
Practice Address - State:PA
Practice Address - Zip Code:18036-9702
Practice Address - Country:US
Practice Address - Phone:610-967-3951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003891L111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition