Dewane D. Frase, D.C.
Individual provider Active NPI Chiropractor · Phillips, WI
NPI 1720169683 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720169683
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 3088-012 (WI)
- Practice address
- N9691 State Highway 13
Phillips, WI 54555-7771 - Phone
- (715) 339-2052
- Fax
- (715) 339-2014
- NPI assigned
- Oct 18, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3088-012 | WI | MD | Chiropractor |
| 1967 | GA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complete Spine Solutions, PC | Chiropractor | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3088-012 | WI | Yes |
Addresses
Primary practice location
N9691 State Highway 13
Phillips, WI 54555-7771
Mailing address
N9691 State Highway 13
Phillips, WI 54555-7771
Phone (715) 339-2052
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38939800 | Medicaid | WI | |
| 5820107910001 | Other | WI | BLUE CROSS & BLUE SHIELD |
Other providers in Phillips, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.