Individual
KAITLYN YVONNE FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, NR-EMT, OPE-C
Contact information
Practice address
300 E COLLEGE AVE, HARTSVILLE, SC 29550-3742
(843) 383-8000
Mailing address
2040 ROSE ST, CARLETON, MI 48117-9510
(734) 624-5370
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/02/2020
Last updated
06/20/2022
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