Provider Demographics
NPI:1417429499
Name:FRIER, JESSICA (LAC)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:FRIER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4640 NICOLS RD STE 207
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-2584
Mailing Address - Country:US
Mailing Address - Phone:651-444-8869
Mailing Address - Fax:
Practice Address - Street 1:4640 NICOLS RD STE 207
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-2584
Practice Address - Country:US
Practice Address - Phone:651-444-8869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-01
Last Update Date:2019-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1826171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist