Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 0831 | AK |
NPI | 1083812507 |
---|---|
Provider Name | Annette Freymueller |
First Address | Fairbanks, AK 99709-6744 |
Second Address | Fairbanks, AK 99709-6744 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PT0831 | (05) | AK |