Provider Demographics
NPI:1487771309
Name:FREUDIGER, STACI M (PT, MBA)
Entity type:Individual
Prefix:MS
First Name:STACI
Middle Name:M
Last Name:FREUDIGER
Suffix:
Gender:F
Credentials:PT, MBA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:15800 TRADITIONS BLVD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1125
Mailing Address - Country:US
Mailing Address - Phone:405-642-4267
Mailing Address - Fax:405-605-8638
Practice Address - Street 1:825 N BROADWAY AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-6039
Practice Address - Country:US
Practice Address - Phone:405-609-3600
Practice Address - Fax:877-887-5107
Is Sole Proprietor?:No
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK3466225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist