Freter Family Practice PLLC
Family Medicine in Lakeside, AZ. Organization (NPI-2).
NPI number1609181718
StatusActive
Last updated in NPPESAug 12, 2010
Details
- NPI
- 1609181718
- Entity type
- Organization (NPI-2)
- Legal business name
- Freter Family Practice PLLC
- Organization subpart
- No
- Enumeration date
- Aug 12, 2010
- Last updated
- Aug 12, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
5448 S. White Mountain Blvd270
Lakeside, AZ 85929
Phone 928-532-5838
Mailing address
5448 S. White Mountain Blvd270
Lakeside, AZ 85929
Authorized official
Mark A Freter
Phycician/Owner
9285325838
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