Provider Demographics
NPI:1891588661
Name:FROBOESE, CONNOR (DPT)
Entity type:Individual
Prefix:
First Name:CONNOR
Middle Name:
Last Name:FROBOESE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30414 TOWN CENTER DR APT 1524
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-6877
Mailing Address - Country:US
Mailing Address - Phone:760-419-6786
Mailing Address - Fax:
Practice Address - Street 1:30414 TOWN CENTER DR APT 1524
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-6877
Practice Address - Country:US
Practice Address - Phone:760-419-6786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT305218225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist