Provider Demographics
NPI:1619122595
Name:FRITSCH, ANDREW CLAYTON (LAC)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:CLAYTON
Last Name:FRITSCH
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4944 ABBOTT AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410-1707
Mailing Address - Country:US
Mailing Address - Phone:612-817-4755
Mailing Address - Fax:952-922-5003
Practice Address - Street 1:6545 FRANCE AVE S STE C21
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2181
Practice Address - Country:US
Practice Address - Phone:952-922-5000
Practice Address - Fax:952-922-5003
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN1454171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist