Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 5491 | OR |
NPI | 1366851347 |
---|---|
Provider Name | Dr. Timothy Luke Frieh |
First Address | Eugene, OR 97402-3710 |
Second Address | Eugene, OR 97402-3710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2014 |
Last Update Date | 04/08/2014 |