Provider Demographics
NPI:1083746218
Name:FRYER, ELIZABETH ANN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:FRYER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 RIVERWAY DR
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-2634
Mailing Address - Country:US
Mailing Address - Phone:703-501-2349
Mailing Address - Fax:
Practice Address - Street 1:155 RIVERWAY DR
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-2634
Practice Address - Country:US
Practice Address - Phone:703-501-2349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305006319261QP2000X
FLPT35758261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA187378OtherPHCS
VA200552261OtherTRICARE
VA195301OtherANTHEM BCBS OF VA
VA5975241OtherAETNA
VA503474OtherNCPPO
VAK0910001OtherBCBS CAREFIRST
VA5975241OtherAETNA