Individual
KELLY DAMIAN FREDERICK
Active
Individual
KELLY DAMIAN FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
176P00000X
Funeral Director
Primary
FD-014493-L
PA
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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