Individual
STACY A FREDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
10787 RANDOLPH ST STE 220, WINFIELD, IN 46307-7615
(219) 333-5900
Mailing address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 576-6200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010467A
IN
Other
Enumeration date
04/12/2013
Last updated
12/17/2024
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