Provider Demographics
NPI:1649713959
Name:FREIER, WILLIAM STEPHEN (1545080)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:STEPHEN
Last Name:FREIER
Suffix:
Gender:M
Credentials:1545080
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W7808 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HOLMEN
Mailing Address - State:WI
Mailing Address - Zip Code:54636-9410
Mailing Address - Country:US
Mailing Address - Phone:608-792-1635
Mailing Address - Fax:
Practice Address - Street 1:2045 32ND ST S
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-7026
Practice Address - Country:US
Practice Address - Phone:608-792-1635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-18
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15450175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath