Provider Demographics
NPI:1437592037
Name:FRYDENLUND, BEVERLY ANN (BS PHYSICAL THERAPY)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:ANN
Last Name:FRYDENLUND
Suffix:
Gender:F
Credentials:BS PHYSICAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17154 740TH ST
Mailing Address - Street 2:
Mailing Address - City:HAYFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55940-8535
Mailing Address - Country:US
Mailing Address - Phone:507-459-8800
Mailing Address - Fax:
Practice Address - Street 1:17154 740TH ST
Practice Address - Street 2:
Practice Address - City:HAYFIELD
Practice Address - State:MN
Practice Address - Zip Code:55940-8535
Practice Address - Country:US
Practice Address - Phone:507-459-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-12
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2190225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist