Provider Demographics
NPI:1225030851
Name:FRYE, JANICE JUANITA (DC)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:JUANITA
Last Name:FRYE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9924 MIDLOTHIAN TPKE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4814
Mailing Address - Country:US
Mailing Address - Phone:804-320-9050
Mailing Address - Fax:804-320-9048
Practice Address - Street 1:9924 MIDLOTHIAN TPKE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4814
Practice Address - Country:US
Practice Address - Phone:804-320-9050
Practice Address - Fax:804-320-9048
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000663111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAV194111Medicare UPIN