Individual
MR. ALTON FREDERICKS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
825 W LINEBAUGH AVE, TAMPA, FL 33612-7855
(954) 649-0555
Mailing address
825 W LINEBAUGH AVE, TAMPA, FL 33612-7855
(954) 649-0555
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT10130
FL
Other
Enumeration date
12/04/2019
Last updated
12/04/2019
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