Organization
FREDERIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTA R FREDERIC DPT, OCS, CSCS (OWNER)
(301) 421-1125
Entity
Organization
Contact information
Practice address
9881 BROKEN LAND PKWY, SUITE 103, COLUMBIA, MD 21046-1172
(240) 841-2639
(301) 500-2175
Mailing address
PO BOX 356, BURTONSVILLE, MD 20866-0356
(301) 421-1125
(301) 500-2175
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/21/2016
Last updated
12/21/2016
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