Provider Demographics
NPI:1205076825
Name:FRISCH, JONI L (DTV)
Entity type:Individual
Prefix:MS
First Name:JONI
Middle Name:L
Last Name:FRISCH
Suffix:
Gender:F
Credentials:DTV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62650-2130
Mailing Address - Country:US
Mailing Address - Phone:217-470-4400
Mailing Address - Fax:217-479-4479
Practice Address - Street 1:658 E STATE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650-2130
Practice Address - Country:US
Practice Address - Phone:217-470-4400
Practice Address - Fax:217-479-4479
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-21
Last Update Date:2009-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist