TONY DAVID FREDERICKS

ELIZABETHTOWN, KY
NPI1174236624
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy175T00000X Peer Specialist
Enumeration Date2022-12-29
Last Update Date2022-12-29
Business Address
TONY DAVID FREDERICKS
100 PAR LN STE 102
ELIZABETHTOWN, KY 42701-9059
Phone number: 270-312-2500
Mailing Address
TONY DAVID FREDERICKS
100 PAR LN STE 102
ELIZABETHTOWN, KY 42701-9059
Phone number:
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