Individual
DR. JASON A FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
5011 W UNION HILLS DR, GLENDALE, AZ 85308-1441
(602) 896-0257
Mailing address
9450 W CABELA DR, APT. 2338, GLENDALE, AZ 85305-1304
(330) 240-0162
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S018631
AZ
Other
Enumeration date
08/11/2011
Last updated
08/11/2011
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