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John C Fredrick, LPO
Prosthetic/Orthotic Supplier in Gotha, Florida
NPI 1922600345

John C Fredrick is a Prosthetic/Orthotic Supplier based in Gotha, FL. John C Fredrick practices in Gotha, FL and has the professional credentials of LPO. The NPI Number for John C Fredrick is 1922600345 and holds a License No. POR13 (Florida).

The current practice location address for John C Fredrick is 9259 Lake Fischer Blvd, Gotha, FL and can be reached out via phone at 850-247-8975.

Location: 9259 Lake Fischer Blvd, Gotha, FL, 34734-5204
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1922600345
Provider Name
John C Fredrick
Credential
LPO
Provider Entity Type
Individual
Gender
Male
Address
9259 Lake Fischer Blvd, Gotha, FL, 34734-5204
Phone Number
850-247-8975
Fax Number
Provider Enumeration Date
11/10/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
9259 Lake Fischer Blvd
City
Gotha
State
Florida
Zip
34734-5204
Phone Number
850-247-8975
Fax Number
person
Provider Business Mailing Address Details
Address
9259 Lake Fischer Blvd
City
Gotha
State
Florida
Zip
34734-5204
Phone Number
850-247-8975
Fax Number
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
POR13 (Florida)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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