Provider Demographics
NPI:1538323290
Name:FRYE, BLAIR A (PT)
Entity Type:Individual
Prefix:MR
First Name:BLAIR
Middle Name:A
Last Name:FRYE
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 1:11808 HOSTER RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-9778
Mailing Address - Country:US
Mailing Address - Phone:317-947-4833
Mailing Address - Fax:
Practice Address - Street 1:11808 HOSTER RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-9778
Practice Address - Country:US
Practice Address - Phone:317-947-4833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009468A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist