Provider Demographics
NPI:1083812507
Name:FREYMUELLER, ANNETTE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:FREYMUELLER
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1258 VIEWPOINTE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-6744
Mailing Address - Country:US
Mailing Address - Phone:907-479-3550
Mailing Address - Fax:907-479-3545
Practice Address - Street 1:1258 VIEWPOINTE DR
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-6744
Practice Address - Country:US
Practice Address - Phone:907-479-3550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK08312251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKPT0831Medicaid