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NPI Code Detail

MEDICARE: MR. JAY ASBURY FRY LISW

MEDICARE: MR. JAY ASBURY FRY LISW
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
1104100000XSocial WorkerI-0007081OH

General Provider Information

NPI Number : 1578665766
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAY ASBURY FRY LISW
Provider Business Mailing Address
First Line : 447 GLENSIDE LN
Second Line :
City : POWELL
State : OH
Zip : 43065-9485
Country : US
Telephone Number : 740-549-0145
Fax Number :
Provider Business Practice Location Address
First Line : 7100 GRAPHICS WAY STE 3100
Second Line :
City : LEWIS CENTER
State : OH
Zip : 43035-0238
Country : US
Telephone Number : 740-428-0428
Fax Number : 740-909-4077
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2006
Last Update Date : 12/05/2024

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