Provider Demographics
NPI:1336887793
Name:FRIESEN, ABIGAIL MARY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MARY
Last Name:FRIESEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 DEL RIO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-4719
Mailing Address - Country:US
Mailing Address - Phone:913-912-0094
Mailing Address - Fax:
Practice Address - Street 1:211 TANK FARM RD STE A
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7509
Practice Address - Country:US
Practice Address - Phone:805-439-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty