Provider Demographics
NPI:1497922249
Name:FRALEY, LINDA C (LPTA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:C
Last Name:FRALEY
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33426 OLD SALISBURY ROAD
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28002
Mailing Address - Country:US
Mailing Address - Phone:704-986-4481
Mailing Address - Fax:
Practice Address - Street 1:33426 OLD SALISBURY ROAD
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28002
Practice Address - Country:US
Practice Address - Phone:704-986-4481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC824225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant