Provider Demographics
NPI:1124366521
Name:FRISCH, ANGI RENEE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ANGI
Middle Name:RENEE
Last Name:FRISCH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 S CABLE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-3467
Mailing Address - Country:US
Mailing Address - Phone:419-236-3739
Mailing Address - Fax:419-224-6800
Practice Address - Street 1:825 S CABLE RD
Practice Address - Street 2:SUITE B
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-3467
Practice Address - Country:US
Practice Address - Phone:419-236-3739
Practice Address - Fax:419-224-6800
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-21
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.017922E-G172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist