Jacob Fredericks
NPI #1356066120 in Springfield, Illinois
Provider Information
- NPI Number
- 1356066120
- Entity Type
- Individual
- Name
- Jacob Fredericks
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Pharmacist
- Enumeration Date
- Oct 5, 2022
- Last Updated
- Oct 5, 2022
Practice Location
- Address
- 3100 S MACARTHUR BLVD
- City
- Springfield
- State
- Illinois
- ZIP Code
- 62704-5800
- Phone
- (217) 528-4926
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacist |
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