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

PAUL FREDERICK

Active Sole Proprietor

PAUL FREDERICK is a Physical Therapy Clinic healthcare provider located in SOUTH HAVEN, Michigan. NPI 1790881290 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Clinic · SOUTH HAVEN, MI

Registration Details

NPI Number
1790881290
Provider Type
Individual
Gender
Male
NPI Issued
Sep 15, 2006 (19.93066039343 yrs)
Last Updated
Mar 20, 2008
License
M15501011004 (MI)
Sole Proprietor
Yes

Practice Information

Address
02957 73RD ST
SOUTH HAVEN, MI, 490909364
Browse MI providers · Browse ZIP 49090
Phone
2696379099
Fax
2696379224
Primary Specialty
Physical Therapy Clinic
261QP2000X
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.