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1376084970
MARY L FREDRICK
COLUMBIA, SC
NPI
1376084970
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: SC 20853)
Enumeration Date
2017-03-15
Last Update Date
2018-08-14
Business Address
Mrs. MARY L FREDRICK APRN
731 POLO ROAD
COLUMBIA, SC 29223
Phone number: 800-491-0909
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Mailing Address
Mrs. MARY L FREDRICK APRN
1624 MAIN ST
COLUMBIA, SC 29201-2818
Phone number: 803-726-2350
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