Noel Fredericksen

NPI #1073067401 in Mahtomedi, Minnesota

Provider Information

NPI Number: 1073067401
Entity Type: Individual
Name: Noel Fredericksen
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Chiropractor
Enumeration Date: Aug 15, 2016
Last Updated: Aug 15, 2016

Practice Location

Address: 55 ELM ST
City: Mahtomedi
State: Minnesota
ZIP Code: 55115-1614
Phone: (612) 990-4478

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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