Provider Demographics
NPI:1952179095
Name:FREHNER, MICHAEL DENZEL
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DENZEL
Last Name:FREHNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7871 W CHARLESTON BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8337
Mailing Address - Country:US
Mailing Address - Phone:702-979-4468
Mailing Address - Fax:
Practice Address - Street 1:7871 W CHARLESTON BLVD STE 160
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-8337
Practice Address - Country:US
Practice Address - Phone:702-979-4468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier