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1811525108
THOMAS FREDERICKS
ORANGE PARK, FL
NPI
1811525108
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-03-31
Last Update Date
2020-05-06
Business Address
THOMAS FREDERICKS DO
2001 KINGSLEY AVE
ORANGE PARK, FL 32073-5148
Phone number: 904-639-8500
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Mailing Address
THOMAS FREDERICKS DO
2001 KINGSLEY AVE
ORANGE PARK, FL 32073-5148
Phone number: 904-639-8500
Copy
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