Provider Demographics
NPI:1407556251
Name:FREY, ANDREA JANE (PT, DPT, ATC, CLT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JANE
Last Name:FREY
Suffix:
Gender:F
Credentials:PT, DPT, ATC, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 GREEN VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7870
Mailing Address - Country:US
Mailing Address - Phone:907-252-6350
Mailing Address - Fax:
Practice Address - Street 1:250 HOSPITAL PL
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-6999
Practice Address - Country:US
Practice Address - Phone:907-714-4404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPHYP21712251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic