Organization
FREDERICK CUSTOMEYEZ IN ST. LOUIS
Active
Parent organization
FREDERICK CUSTOMEYEZ PROSTHETICS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FREDERICK CUSTOMEYEZ PROSTHETICS LLC
Authorized official
MELISSA FREDERICK (OWNER)
(401) 584-3939
Entity
Organization
Contact information
Practice address
1834 CRAIG RD, SAINT LOUIS, MO 63146-4712
(401) 584-3939
Mailing address
9278 PARADISE DR, PANAMA CITY BEACH, FL 32413-9625
(401) 584-3939
(216) 678-9186
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/06/2023
Last updated
07/03/2025
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