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General NPI Number Information
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NPI Number | 1811392814
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Entity Type | Individual
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Provider Name | JOHNI FRAYKOR CMT
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Gender | Female
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Dates
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Enumeration Date | 11/03/2014
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Last Update Date | 11/03/2014
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Provider Practice Location Address
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Address Line | 2891 ANDERSON HWY
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City | POWHATAN
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State | VA
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Zip | 23139-7406
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Country | US
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Telephone | 804-897-1259
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Fax | 804-897-6141
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Provider Business Mailing Address
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Address Line | 9971 ANDERSONVILLE RD
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City | DILLWYN
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State | VA
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Zip | 23936-2061
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Country | US
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Telephone | 804-897-1259
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Fax | 804-897-6141
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 0019009858
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License Number State | VA
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