Individual
MR. JOHN FREDERICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2510 WESTCHESTER AVE, SUITE 110, BRONX, NY 10461-3585
(718) 684-3050
Mailing address
2510 WESTCHESTER AVE, SUITE 110, BRONX, NY 10461-3585
(718) 684-3050
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
020375
NY
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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