Individual
DR. ETHAN DALE FRACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1506 S MADISON ST, WEBB CITY, MO 64870-2901
(417) 673-5556
(417) 673-5088
Mailing address
1506 S MADISON ST, WEBB CITY, MO 64870-2901
(417) 673-5556
(417) 673-5088
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2022042096
MO
Other
Enumeration date
11/02/2022
Last updated
11/02/2022
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