Provider Demographics
NPI:1376501874
Name:FRAZIER, WILLIAM A (PT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:A
Last Name:FRAZIER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 SOUTH ST
Mailing Address - Street 2:BOW PHYSICAL THERAPY
Mailing Address - City:BOW
Mailing Address - State:NH
Mailing Address - Zip Code:03304-3416
Mailing Address - Country:US
Mailing Address - Phone:603-224-5883
Mailing Address - Fax:603-224-6042
Practice Address - Street 1:501 SOUTH ST
Practice Address - Street 2:BOW PHYSICAL THERAPY
Practice Address - City:BOW
Practice Address - State:NH
Practice Address - Zip Code:03304-3416
Practice Address - Country:US
Practice Address - Phone:603-224-5883
Practice Address - Fax:603-224-6042
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2804225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
3318117OtherAETNA
NH1843OtherHARVARD PILGRIM
50174OtherCIGNA HEALTHCARE
NH08Y004203NH01OtherBLUE CROSS
NH30394005Medicaid
DA2947OtherMEDICARE RAILROAD
50174OtherCIGNA HEALTHCARE