Individual
LORI A FREDERICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3580 ARCADE ST, VADNAIS HEIGHTS, MN 55127-7135
(651) 968-5201
Mailing address
710 COMMERCE DR STE 200, WOODBURY, MN 55125-4925
(651) 968-5201
(651) 968-5904
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4907
MN
Other
Enumeration date
06/13/2016
Last updated
07/21/2022
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