Individual
FREDRICK LEE EAGLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 E WOODHURST DR STE Q100, SPRINGFIELD, MO 65804-4240
(417) 877-1300
Mailing address
1200 E WOODHURST DR STE Q100, SPRINGFIELD, MO 65804-4240
(417) 877-1300
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2002017980
MO
2472E0500X
EEG Technician
—
—
Other
Enumeration date
10/10/2019
Last updated
10/10/2019
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