Justin Fredericksen Valid NPI

Individual provider · Pharmacist · Falcon, CO

NPI

1174851612

Type

Individual (Type 1)

Primary specialty

Pharmacist

Specialty group

Pharmacy Service Providers

Taxonomy code

183500000X

License number

0020781 (CO)

Sex

Male

Sole proprietor

Yes

Enumerated

2009-11-20

Last updated

2025-10-21