Healthcare Provider Details

I. General information

NPI: 1225697527
Provider Name (Legal Business Name): KAYLA STUMP FRAZIER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2019
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18596 LEE HWY STE B
ABINGDON VA
24210-8004
US

IV. Provider business mailing address

711 CURVE RD
PEARISBURG VA
24134-1404
US

V. Phone/Fax

Practice location:
  • Phone: 276-525-6043
  • Fax:
Mailing address:
  • Phone: 540-599-6280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305208923
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: