MEDICARE: ELIZABETH ANN FRYER PT, DPT

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
1	261QP2000X	Physical Therapy Clinic/Center	2305006319	VA
2	261QP2000X	Physical Therapy Clinic/Center	PT35758	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	187378	OTHER	VA	PHCS
2	200552261	OTHER	VA	TRICARE
3	195301	OTHER	VA	ANTHEM BCBS OF VA
4	5975241	OTHER	VA	AETNA
5	503474	OTHER	VA	NCPPO
6	K0910001	OTHER	VA	BCBS CAREFIRST

General Provider Information

NPI Number	:	1083746218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ANN FRYER PT, DPT

Provider Business Mailing Address
First Line	:	155 RIVERWAY DR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32963-2634
Country	:	US
Telephone Number	:	703-501-2349
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 RIVERWAY DR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32963-2634
Country	:	US
Telephone Number	:	703-501-2349
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	01/23/2023

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