Provider Demographics
NPI:1346494507
Name:FRALEIGH, WAYNE FRANCIS
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:FRANCIS
Last Name:FRALEIGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2231 E SUMA DR
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85650-8444
Mailing Address - Country:US
Mailing Address - Phone:520-266-1388
Mailing Address - Fax:
Practice Address - Street 1:2231 E SUMA DR
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85650-8444
Practice Address - Country:US
Practice Address - Phone:520-266-1388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ55322251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic