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NPI Code Detail

MEDICARE: MRS. KRISTA R FREDERIC MPT

MEDICARE: MRS. KRISTA R FREDERIC MPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist22235MD

General Provider Information

NPI Number : 1952370777
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTA R FREDERIC MPT
Provider Business Mailing Address
First Line : PO BOX 356
Second Line :
City : BURTONSVILLE
State : MD
Zip : 20866-0356
Country : US
Telephone Number : 301-421-1125
Fax Number : 301-421-1077
Provider Business Practice Location Address
First Line : 3901 NATIONAL DR STE 100
Second Line :
City : BURTONSVILLE
State : MD
Zip : 20866-1176
Country : US
Telephone Number : 301-421-1125
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2006
Last Update Date : 10/15/2024

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Directions to “ MRS. KRISTA R FREDERIC MPT” Practice Location

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