Individual
MR. DAVID LAYNE FREDERICK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
1050 JABARRAH AVE, SEYMOUR JOHNSON A F B, NC 27531-2310
(919) 722-1522
Mailing address
405 WOODHILLE DR, GOLDSBORO, NC 27530-9066
(919) 648-8310
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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