Individual
MR. DALE A FRIESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
5535 DELMAR BLVD, SAINT LOUIS, MO 63112-3005
(314) 879-6363
(314) 879-6372
Mailing address
5535 DELMAR BLVD, SAINT LOUIS, MO 63112-3005
(314) 879-6363
(314) 879-6372
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2006007794
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000097542
—
MO
Enumeration date
04/12/2007
Last updated
09/28/2011
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