Larry Alan Fredericks

NPI #1700473550 in Nappanee, Indiana

Provider Information

NPI Number
1700473550
Entity Type
Individual
Name
Larry Alan Fredericks
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Pharmacist
Enumeration Date
Dec 28, 2020
Last Updated
Dec 28, 2020

Practice Location

Address
242 N OAKLAND AVE
State
Indiana
ZIP Code
46550-2319
Phone
(574) 773-7873

Specialties & Taxonomy Codes

Specialty
Pharmacist

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