Provider Demographics
NPI:1740807510
Name:FRIKKEN FITNESS, L.L.C.
Entity type:Organization
Organization Name:FRIKKEN FITNESS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIKKEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:320-282-0308
Mailing Address - Street 1:8300 ZANE AVE N APT 101
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-2143
Mailing Address - Country:US
Mailing Address - Phone:320-282-0308
Mailing Address - Fax:
Practice Address - Street 1:8507 JEFFERSON LN N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-2117
Practice Address - Country:US
Practice Address - Phone:320-282-0308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-28
Last Update Date:2020-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN11870OtherDPT LICENSE