Individual
KYLE FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2 REGENCY PLZ STE 3, PROVIDENCE, RI 02903-3149
(401) 484-1706
(401) 437-6959
Mailing address
2 REGENCY PLZ STE 3, PROVIDENCE, RI 02903-3149
(401) 484-1706
(401) 437-6959
Taxonomy
Speciality
Code
Description
License number
State
2472E0500X
EEG Technician
Primary
—
—
Other
Enumeration date
12/21/2017
Last updated
12/21/2017
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