Provider Demographics
NPI:1942416466
Name:FRIEL, PATRICIA W (PTA)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:W
Last Name:FRIEL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14247 VICTOR DR.
Mailing Address - Street 2:PO BOX 2241
Mailing Address - City:SEWARD
Mailing Address - State:AK
Mailing Address - Zip Code:99664-2241
Mailing Address - Country:US
Mailing Address - Phone:907-224-5134
Mailing Address - Fax:907-224-5134
Practice Address - Street 1:14247 VICTOR DR.
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:AK
Practice Address - Zip Code:99664-2241
Practice Address - Country:US
Practice Address - Phone:907-224-5134
Practice Address - Fax:907-224-5134
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1039225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant