Provider Demographics
NPI:1366559379
Name:FRIESEN, TROY WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:TROY
Middle Name:WILLIAM
Last Name:FRIESEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3080 BROOKDALE DR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55444-1845
Mailing Address - Country:US
Mailing Address - Phone:763-566-6401
Mailing Address - Fax:763-585-1697
Practice Address - Street 1:4632 85TH AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1957
Practice Address - Country:US
Practice Address - Phone:763-494-4900
Practice Address - Fax:763-494-4902
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN3157111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN5862175-00Medicaid
MN350001209Medicare ID - Type Unspecified
MN5862175-00Medicaid