Individual
LAURA FREDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
762 CLEVELAND AVE S, SAINT PAUL, MN 55116-1347
(312) 391-0605
Mailing address
1512 MINNEHAHA AVE W, SAINT PAUL, MN 55104-1207
(312) 391-0605
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
03/09/2015
Last updated
03/09/2015
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