Healthcare Provider Details

I. General information

NPI: 1760306575
Provider Name (Legal Business Name): FROST & FYRE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N MARKET ST STE B
BENSON NC
27504-1514
US

IV. Provider business mailing address

101 N MARKET ST STE B
BENSON NC
27504-1514
US

V. Phone/Fax

Practice location:
  • Phone: 984-252-8333
  • Fax: 919-661-8195
Mailing address:
  • Phone: 984-252-8333
  • Fax: 919-661-8195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. KATINA BLUE
Title or Position: OWNER
Credential: EDD
Phone: 984-252-8333