Organization
DENISE B. FREDERICKS, PT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENISE BUNDRICK FREDERICKS PT (PHYSICAL THERAPIST)
(843) 906-5210
Entity
Organization
Contact information
Practice address
1636 OAK ISLAND DR, CHARLESTON, SC 29412-9519
(843) 762-6793
(843) 762-1154
Mailing address
1636 OAK ISLAND DR, CHARLESTON, SC 29412-9519
(843) 762-6793
(843) 762-1154
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1623
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH0142
—
SC
Enumeration date
03/17/2006
Last updated
08/22/2020
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