Individual
JOSEPH JACK FREDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
6255 SAWCUT PT, FOUNTAIN, CO 80817-1867
(719) 359-9080
(719) 234-1179
Mailing address
6255 SAWCUT PT, FOUNTAIN, CO 80817-1867
(719) 359-9080
(719) 234-1179
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051298597
IL
183500000X
Pharmacist
Primary
PHA.0023944
CO
Other
Enumeration date
05/19/2020
Last updated
07/18/2026
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