Individual
MRS. DONNA MARIE FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
3310 CORDES DR, SAINT LOUIS, MO 63125-4430
(314) 894-3547
Mailing address
3310 CORDES DR, SAINT LOUIS, MO 63125-4430
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
104699
MO
Other
Enumeration date
04/29/2009
Last updated
04/29/2009
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