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Individual

DR. JUSTIN FREDERICKSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
11550 MERIDIAN MARKET VW, FALCON, CO 80831-8241
(719) 522-2989
Mailing address
11550 MERIDIAN MARKET VW, FALCON, CO 80831-8241
(719) 522-2989

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0020781
CO

Other

Enumeration date
11/20/2009
Last updated
10/21/2025
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