Healthcare Provider Details

I. General information

NPI: 1952610263
Provider Name (Legal Business Name): AMY LOUISE FRITCHMAN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2010
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S NEW ST
DOVER DE
19904-3571
US

IV. Provider business mailing address

235 TRACER DR
CLAYTON DE
19938-3807
US

V. Phone/Fax

Practice location:
  • Phone: 302-730-4985
  • Fax:
Mailing address:
  • Phone: 302-223-6593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License NumberMT0002898
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMT-0002898
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT-0002898
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: