Provider Demographics
NPI:1942612973
Name:FRIEDLI, CASSANDRA (DPT)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:FRIEDLI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16251 JATOS CIR
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-6616
Mailing Address - Country:US
Mailing Address - Phone:952-465-4175
Mailing Address - Fax:
Practice Address - Street 1:900 W 94TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420-4206
Practice Address - Country:US
Practice Address - Phone:651-738-9888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-26
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3134225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist