Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 48699 | CO |
N | 2081P2900X | Pain Medicine | 48699 | CO |
Y | 2081S0010X | Sports Medicine | 48699 | CO |
Y | 213ES0000X | Sports Medicine | 48699 | CO |
NPI | 1528140191 |
---|---|
Provider Name | Jason M Friedrich |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 15/03/2019 |