Fritz, Brenda M

Fritz, Brenda M is an individual health care provider with primary practice located at 2570 Channing Way , Idaho Falls ID 83404-7515. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Fritz, Brenda M can be contacted via phone (208) 529-8005.

Contact Information

Primary practice address
2570 Channing Way Idaho Falls ID 83404-7515
Phone: (208) 529-8005
Fax: (208) 529-0251
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X PT-1468 Idaho

Profile Details

NPI number 1093860710
LBN Legal business name Fritz, Brenda M
Credentials Master of Physical Therapy (MPT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2007
Last updated Aug 4th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093860710 NPPES
Idaho Other 000010026646 BLUE SHIELD OF IDAHO ID#
Idaho Other T-383-7 BLUE SHIELD OF IDAHO ID#
Idaho MEDICAID 805618400 BLUE SHIELD OF IDAHO ID#
Idaho Other 82-0510764 BLUE SHIELD OF IDAHO ID#

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