Kelly Damian Frederick

NPI #1588112015 in Latrobe, Pennsylvania

Provider Information

NPI Number: 1588112015
Entity Type: Individual
Name: Kelly Damian Frederick
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Funeral Director
Enumeration Date: Sep 13, 2016
Last Updated: Sep 13, 2016

Practice Location

Address: 1543 LIGONIER ST
City: Latrobe
State: Pennsylvania
ZIP Code: 15650-2955
Phone: (724) 537-7766

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Funeral Director	176P00000X	Primary

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