Individual
JOHN FREDENBURGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 HALL AVE STE A, MARINETTE, WI 54143-1656
(715) 732-7760
Mailing address
2500 HALL AVE STE A, MARINETTE, WI 54143-1656
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/12/2019
Last updated
12/12/2019
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