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Organization
MEDPRO, LLC
Active
Organization
MEDPRO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY FREDERIKSEN SR. (MEMBER)
(479) 459-6354
Entity
Organization
Contact information
Practice address
5123 FIGURE FIVE HTS, RUDY, AR 72952-9417
(479) 459-6354
Mailing address
PO BOX 6691, VAN BUREN, AR 72956-0601
(479) 459-6354
(479) 459-6354
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
Other
Enumeration date
06/18/2024
Last updated
06/18/2024
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