Healthcare Provider Details

I. General information

NPI: 1720481591
Provider Name (Legal Business Name): FRIEDRICHS PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2014
Last Update Date: 02/24/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 HIGHWAY K
O FALLON MO
63368
US

IV. Provider business mailing address

2315 HIGHWAY K
O FALLON MO
63368-8659
US

V. Phone/Fax

Practice location:
  • Phone: 636-265-1505
  • Fax: 636-266-2112
Mailing address:
  • Phone: 636-265-1505
  • Fax: 636-266-2112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID ANTHONY FRIEDRICHS
Title or Position: PRESIDENT
Credential: DPT, CMPT
Phone: 636-385-5277