Individual
MRS. JENNA DAWN FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
918 N READING RD, EPHRATA, PA 17522-9794
(717) 335-2338
Mailing address
1205 RIDGE AVE, EPHRATA, PA 17522-9782
(610) 507-5512
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG012637
PA
Other
Enumeration date
10/18/2018
Last updated
10/18/2018
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