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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

ALYSSA L FREDERICKS

Active Sole Proprietor

ALYSSA L FREDERICKS is a Athletic Trainer healthcare provider located in POLACCA, Arizona. NPI 1497222681 is currently active in the NPPES registry. Verify at CMS.

Athletic Trainer · POLACCA, AZ

Registration Details

NPI Number
1497222681
Provider Type
Individual
Gender
Female
NPI Issued
Oct 26, 2018 (7.8167670834661 yrs)
Last Updated
Oct 26, 2018
License
ATR-001676 (AZ)
Sole Proprietor
Yes

Practice Information

Address
HWY 264 MILEPOST 388
UNIT 40
POLACCA, AZ, 86042
Browse AZ providers · Browse ZIP 86042
Phone
9287370414
Primary Specialty
Athletic Trainer
2255A2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.