Provider Demographics
NPI:1720592686
Name:FRIESEN, PETER (DPT)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:FRIESEN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 VILLAGE PARK DR
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-7044
Mailing Address - Country:US
Mailing Address - Phone:919-217-0113
Mailing Address - Fax:919-217-0059
Practice Address - Street 1:4005 VILLAGE PARK DR
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-7044
Practice Address - Country:US
Practice Address - Phone:919-217-0113
Practice Address - Fax:919-217-0059
Is Sole Proprietor?:No
Enumeration Date:2017-11-29
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic