Individual
ANTONY FRIERDICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
22 SOUTH 13TH STREET, BELLEVILLE, IL 62220
(618) 541-9751
Mailing address
22 S 13TH ST, BELLEVILLE, IL 62220-1834
(618) 541-9751
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003858
IL
Other
Enumeration date
09/24/2015
Last updated
09/24/2015
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