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General NPI Number Information
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NPI Number | 1558132449
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Entity Type | Organization
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Legal Business Name | JP FRYE LLC
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Dates
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Enumeration Date | 01/10/2024
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Last Update Date | 02/18/2024
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Provider Practice Location Address
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Address Line | 5254 POTOMAC DR STE A
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City | KING GEORGE
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State | VA
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Zip | 22485-5832
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Country | US
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Telephone | 540-709-1147
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Fax |
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Provider Business Mailing Address
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Address Line | 17013 WILMONT RD
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City | KING GEORGE
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State | VA
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Zip | 22485-2817
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Country | US
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Telephone | 540-645-3099
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMES PRESTON FRYE
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Credential | PERSONAL TRAINER
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Telephone | 540-645-3099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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