Provider Demographics
NPI:1134138068
Name:FRIEDRICHS, REBECCA LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LYNN
Last Name:FRIEDRICHS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 N EDWARDS BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAKE GENEVA
Mailing Address - State:WI
Mailing Address - Zip Code:53147-4504
Mailing Address - Country:US
Mailing Address - Phone:262-248-4105
Mailing Address - Fax:262-248-4127
Practice Address - Street 1:240 N EDWARDS BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-4504
Practice Address - Country:US
Practice Address - Phone:262-248-4105
Practice Address - Fax:262-248-4127
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3366-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor