Individual
MINDY ANN FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
851 NW 45TH ST, KANSAS CITY, MO 64116-4628
(816) 718-2929
Mailing address
9603 E 79TH TER, RAYTOWN, MO 64138-1913
(816) 718-2929
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2009029858
MO
Other
Enumeration date
03/21/2013
Last updated
03/21/2013
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