Individual
MR. MATTHEW EDWARD FRERICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, OTC
Contact information
Practice address
710 COMMERCE DR, WOODBURY, MN 55125-4919
(651) 968-5000
Mailing address
5059 CHERRYBARK LN SE, ROCHESTER, MN 55904-8478
(507) 304-3856
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2556
MN
246ZC0007X
Surgical Assistant
19-0604
MN
Other
Enumeration date
08/15/2013
Last updated
02/07/2020
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