Individual
KEVEN FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4824 SMALLWOOD RD, APT. 69, COLUMBIA, SC 29223-3232
(803) 209-3096
Mailing address
4824 SMALLWOOD RD, APT. 69, COLUMBIA, SC 29223-3232
(803) 209-3096
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3464
SC
Other
Enumeration date
05/08/2009
Last updated
05/08/2009
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