Individual
MELLISSA RAE FRIETCHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CERTIFIED ORTHOTIST
Contact information
Practice address
1246 E WALNUT LAWN ST, SPRINGFIELD, MO 65804-4202
(417) 755-7430
(417) 755-7431
Mailing address
1246 E WALNUT LAWN ST, SPRINGFIELD, MO 65804-4202
(417) 755-7430
(417) 755-7431
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
622556702
—
MO
Enumeration date
08/01/2017
Last updated
08/01/2017
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