Provider Demographics
NPI:1164587952
Name:FRY, MARGARET (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:FRY
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 S PERRY ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-3376
Mailing Address - Country:US
Mailing Address - Phone:720-398-8880
Mailing Address - Fax:720-533-6137
Practice Address - Street 1:815 S PERRY ST STE 200
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-3376
Practice Address - Country:US
Practice Address - Phone:720-398-8806
Practice Address - Fax:720-533-6137
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR1270225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR134958721Medicaid
AR5U198OtherBLUE CROSS BLUE SHIELD
CO9000149056Medicaid