Provider Demographics
NPI:1245379544
Name:FRIEDRICHSEN, BRIDGET M (PT)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:M
Last Name:FRIEDRICHSEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SIOUX VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:ANEROKEE
Mailing Address - State:IA
Mailing Address - Zip Code:51012
Mailing Address - Country:US
Mailing Address - Phone:712-225-1502
Mailing Address - Fax:712-732-5153
Practice Address - Street 1:300 SIOUX VALLEY DR
Practice Address - Street 2:
Practice Address - City:ANEROKEE
Practice Address - State:IA
Practice Address - Zip Code:51012
Practice Address - Country:US
Practice Address - Phone:712-225-1502
Practice Address - Fax:712-732-5153
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA3262225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA41394OtherWELLMARK BCBS OF IOWA