MEDICARE: MRS. ANGI RENEE FRISCH LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172M00000X	Mechanotherapist	33.017922E-G	OH

General Provider Information

NPI Number	:	1124366521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGI RENEE FRISCH LMT

Provider Business Mailing Address
First Line	:	825 S CABLE RD
Second Line	:	SUITE B
City	:	LIMA
State	:	OH
Zip	:	45805-3467
Country	:	US
Telephone Number	:	419-236-3739
Fax Number	:	419-224-6800

Provider Business Practice Location Address
First Line	:	825 S CABLE RD
Second Line	:	SUITE B
City	:	LIMA
State	:	OH
Zip	:	45805-3467
Country	:	US
Telephone Number	:	419-236-3739
Fax Number	:	419-224-6800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2013
Last Update Date	:	01/21/2013

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