Individual
TAMARA FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9348 GRAND CORDERA PKWY STE 160, COLORADO SPRINGS, CO 80924-7023
(719) 355-1585
Mailing address
9348 GRAND CORDERA PKWY STE 160, COLORADO SPRINGS, CO 80924-7023
(719) 355-1585
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0006906
CO
Other
Enumeration date
07/25/2008
Last updated
12/29/2021
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