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General NPI Number Information
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NPI Number | 1265565261
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Entity Type | Individual
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Provider Name | WILLIAM JOSEPH FRYE ATC
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Gender | Male
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 39 MARTINSVILLE ROAD
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City | MARTINSVILLE
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State | NJ
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Zip | 08836
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Country | US
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Telephone | 908-645-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 1348 BUTLER ST
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City | EASTON
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State | PA
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Zip | 18042-4758
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Country | US
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Telephone | 610-258-4044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 25MT00131100
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License Number State | NJ
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