Provider Demographics
NPI:1336887793
Name:FRIESEN, ABIGAIL MARY (PT, DPT)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MARY
Last Name:FRIESEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 E PRATER WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-8973
Mailing Address - Country:US
Mailing Address - Phone:775-331-1199
Mailing Address - Fax:775-331-1180
Practice Address - Street 1:1610 ROBB DR STE D5
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-3520
Practice Address - Country:US
Practice Address - Phone:775-746-9222
Practice Address - Fax:775-746-9224
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-25
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6538225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty