DR. Justin Fredericksen

NPI #1174851612 in Falcon, Colorado

Provider Information

NPI Number: 1174851612
Entity Type: Individual
Name: DR. Justin Fredericksen
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Nov 20, 2009
Last Updated: Oct 21, 2025

Practice Location

Address: 11550 MERIDIAN MARKET VW
City: Falcon
State: Colorado
ZIP Code: 80831-8241
Phone: (719) 522-2989

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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