Organization
FREDERICK FAMILY CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONNA S FREDERICK D.C. (CHIROPRACTOR, OWNER)
(765) 286-9020
Entity
Organization
Contact information
Practice address
3415 W FOX RIDGE LN, MUNCIE, IN 47304-5204
(765) 286-9020
(765) 286-9097
Mailing address
3415 W FOX RIDGE LN, MUNCIE, IN 47304-5204
(765) 286-9020
(765) 286-9097
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08002263A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000478644
ANTHEM
IN
01
—
1296287
AETNA
IN
05
—
200816880A
—
IN
Enumeration date
05/30/2007
Last updated
06/22/2009
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