Provider Demographics
NPI:1851392518
Name:FRIEDRICHS, ROBERT J (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:FRIEDRICHS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1155
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50402-1155
Mailing Address - Country:US
Mailing Address - Phone:641-424-5415
Mailing Address - Fax:641-421-2014
Practice Address - Street 1:940 N TYLER AVE
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-1840
Practice Address - Country:US
Practice Address - Phone:641-424-5415
Practice Address - Fax:641-421-2014
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA91111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0419283Medicaid
IA10954Medicare PIN
IAT01102Medicare UPIN