Individual
MARK JOHN FRILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
445 E 1ST ST, FREMONT, NE 68025-5668
(402) 721-7169
Mailing address
2931 S 112TH ST, OMAHA, NE 68144-4701
(402) 812-5684
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
203
NE
Other
Enumeration date
09/25/2007
Last updated
09/25/2007
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