Individual
FREDERICK MICHAEL DEDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
5615 SUFFIELD CT, COLUMBIA, MD 21044-2775
(412) 477-7163
Mailing address
5615 SUFFIELD CT, COLUMBIA, MD 21044-2775
(412) 477-7163
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
M05957
MD
225700000X
Massage Therapist
MSG002338
PA
Other
Enumeration date
08/17/2022
Last updated
09/13/2022
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