Individual
MICHAEL JACOB FREDERICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 S 1ST ST APT 1, ISHPEMING, MI 49849-2083
(231) 233-3547
Mailing address
201 S 1ST ST APT 1, ISHPEMING, MI 49849-2083
(231) 233-3547
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/09/2017
Last updated
03/09/2017
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