Healthcare Provider Details

I. General information

NPI: 1083425789
Provider Name (Legal Business Name): TIMOTHY JAMES FRYE DPT, PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4040 FAIRFAX DR STE 200
ARLINGTON VA
22203-1613
US

IV. Provider business mailing address

8501 ARLINGTON BLVD STE 200
FAIRFAX VA
22031-4625
US

V. Phone/Fax

Practice location:
  • Phone: 703-284-5980
  • Fax:
Mailing address:
  • Phone: 571-472-4455
  • Fax: 571-665-6425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305218001
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: