Individual
MISS FONDA RONDELLE FRAZIER I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
311 DEPOT ST, YOUNGWOOD, PA 15697-1637
(724) 925-1160
Mailing address
311 DEPOT ST, YOUNGWOOD, PA 15697-1637
(724) 925-1160
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
24066646
PA
Other
Enumeration date
05/16/2023
Last updated
05/16/2023
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