Individual
JUSTIN LEE FREDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MOT
Contact information
Practice address
1431 PREMIER DR, MANKATO, MN 56001-6076
(507) 386-6600
Mailing address
1431 PREMIER DR, MANKATO, MN 56001-6076
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104732
MN
Other
Enumeration date
09/03/2015
Last updated
10/28/2025
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