MEDICARE: FRISCHLY MADE TECH INC.

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	225CA2500X	Assistive Technology Supplier Rehabilitation Counselor

General Provider Information

NPI Number	:	1518551399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRISCHLY MADE TECH INC.

Provider Business Mailing Address
First Line	:	6044 EDGEDALE CIR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-1040
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6044 EDGEDALE CIR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-1040
Country	:	US
Telephone Number	:	419-407-6096
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	BLADE FRISCH
Credential	:	M.ED, M.S.
Telephone Number	:	419-407-6096

Provider Enumeration Date	:	02/23/2021
Last Update Date	:	02/23/2021

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