MEDICARE: MRS. KRISTINE RUTH FRIESEN OTR

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	225X00000X	Occupational Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962565630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTINE RUTH FRIESEN OTR

Provider Business Mailing Address
First Line	:	2921 CHAMPA ST
Second Line	:	UNIT A
City	:	DENVER
State	:	CO
Zip	:	80205-2789
Country	:	US
Telephone Number	:	303-358-6538
Fax Number	:

Provider Business Practice Location Address
First Line	:	2921 CHAMPA ST
Second Line	:	UNIT A
City	:	DENVER
State	:	CO
Zip	:	80205-2789
Country	:	US
Telephone Number	:	303-358-6538
Fax Number	:

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

Provider Enumeration Date	:	12/17/2006
Last Update Date	:	07/08/2007

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