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1104262617
CHAD FREDERICKSON
BATON ROUGE, LA
NPI
1104262617
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2081S0010X Physical Medicine & Rehabilitation, Sports Medicine
(Licence: LA ATH.200132)
Enumeration Date
2013-05-13
Last Update Date
2022-11-02
Business Address
CHAD FREDERICKSON
INFIRMARY RD
BATON ROUGE, LA 70803-2401
Phone number: 225-578-5633
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Mailing Address
CHAD FREDERICKSON
INFIRMARY RD
BATON ROUGE, LA 70803-2401
Phone number: 225-578-5633
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