Provider Information for 1164586855
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Mrs. LYDIA WILCOX FRAZIER
Sex: Female
NPI: 1164586855
Last Updated: 2008-12-02
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1164586855 | ||||||||
| Enumeration Date | 2006-12-20 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 5400 KIRKWOOD BLVD SW FOUR OAKS CEDAR RAPIDS, IA 52404 United States Phone: 319-364-0259 | Fax:866-290-5565 | ||||||||
| Primary Practice Address | 1916 WATERFRONT DR IOWA CITY, IA 52240 United States Phone: 319-337-5080 | Fax:866-293-6326 | ||||||||
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