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Organization

FEDRICK GROUP, LLC

Active
Other names
The Athlete's Foot
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KASINDA FEDRICK (PARTNER)
(678) 377-2788
Entity
Organization

Contact information

Practice address
875 LAWRENCEVILLE SUWANEE RD, SUITE 310, LAWRENCEVILLE, GA 30043-8479
(678) 377-2788
(678) 377-2788
Mailing address
875 LAWRENCEVILLE SUWANEE RD, SUITE 310, LAWRENCEVILLE, GA 30043-8479
(678) 377-2788
(678) 377-2788

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
12/11/2008
Last updated
12/11/2008
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