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NPI Code Detail

MEDICARE: DANIELLE RENEE FRIEDLEIN PT, ATC

MEDICARE:   DANIELLE RENEE FRIEDLEIN  PT, ATC
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
1225100000XPhysical Therapist03538IA
22255A2300XAthletic Trainer00322IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1035276OTHERIABLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164492047
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE RENEE FRIEDLEIN PT, ATC
Provider Business Mailing Address
First Line : 1307 S BROADWAY ST
Second Line :
City : TOLEDO
State : IA
Zip : 52342-2307
Country : US
Telephone Number : 641-484-5253
Fax Number :
Provider Business Practice Location Address
First Line : 1307 S BROADWAY ST
Second Line :
City : TOLEDO
State : IA
Zip : 52342-2307
Country : US
Telephone Number : 641-484-5253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2006
Last Update Date : 01/25/2009

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Directions to “ DANIELLE RENEE FRIEDLEIN PT, ATC” Practice Location

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