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1285077941
STACY A FREDRICKSON
CHESTERTON, IN
NPI
1285077941
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Former Name
STACY A ORRIS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IN 05010467A)
Enumeration Date
2013-04-12
Last Update Date
2019-12-17
Business Address
STACY A FREDRICKSON PT, DPT
748 E PORTER AVE
CHESTERTON, IN 46304-9101
Phone number: 219-255-1566
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Mailing Address
STACY A FREDRICKSON PT, DPT
625 ENTERPRISE DR
OAK BROOK, IL 60523-8813
Phone number: 630-576-6200
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