Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 8819 | TX |
NPI | 1003939745 |
---|---|
Provider Name | Dr. Kam Friedrichs |
First Address | College Station, TX 77845-5474 |
Second Address | College Station, TX 77845-5474 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 08/07/2007 |