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NPI Code Detail

MEDICARE: JENNIFER FRETZ,PLC

MEDICARE: JENNIFER FRETZ,PLC
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
1207Q00000XFamily Medicine PhysicianJF012064MI

General Provider Information

NPI Number : 1679755037
Entity Type Code : Organization
Provider Name (Legal Business Name) : JENNIFER FRETZ,PLC
Provider Business Mailing Address
First Line : 25620 GIBRALTAR RD
Second Line :
City : FLAT ROCK
State : MI
Zip : 48134-1243
Country : US
Telephone Number : 734-789-9355
Fax Number : 734-789-1520
Provider Business Practice Location Address
First Line : 25620 GIBRALTAR RD
Second Line :
City : FLAT ROCK
State : MI
Zip : 48134-1243
Country : US
Telephone Number : 734-789-9355
Fax Number : 734-789-1520
Authorized Official
Title or Position : PRESIDENT
Name : MRS. JENNIFER ELISE FRETZ
Credential : D.O
Telephone Number : 734-789-9355
Provider Enumeration Date : 11/28/2007
Last Update Date : 11/29/2007

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