Provider Demographics
NPI:1073736088
Name:FRISBY, JENNIFER GILL (ATC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:GILL
Last Name:FRISBY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2090 STUDENT LANE
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-8569
Mailing Address - Country:US
Mailing Address - Phone:517-610-2938
Mailing Address - Fax:517-439-1738
Practice Address - Street 1:2090 STUDENT LANE
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-8569
Practice Address - Country:US
Practice Address - Phone:517-610-2938
Practice Address - Fax:517-439-1738
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIPENDING2255A2300X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies