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Individual

MRS. EUNICE DELORES FREDRICKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
6768 N HIGHWAY 67, FLORISSANT, MO 63034-2742
(314) 741-9101
Mailing address
6768 NORTH HWY 67, FLORISSANT, MO 63034
(314) 741-9101

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070017473
IL
225100000X
Physical Therapist
Primary
2009035682
MO

Other

Enumeration date
12/24/2009
Last updated
12/24/2009
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