Individual
FREDDIE FRIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
301 W MYRTLE ST, BOISE, ID 83702-7656
(208) 342-8200
(208) 342-8202
Mailing address
301 W MYRTLE ST, BOISE, ID 83702-7656
(208) 342-8200
(208) 342-8202
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA157
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
804251900
—
ID
Enumeration date
05/16/2006
Last updated
06/08/2011
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