Provider Demographics
NPI:1558328476
Name:FRYE, BRANDIE MARIE (MED, ATC)
Entity Type:Individual
Prefix:MRS
First Name:BRANDIE
Middle Name:MARIE
Last Name:FRYE
Suffix:
Gender:F
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1348 BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-4758
Mailing Address - Country:US
Mailing Address - Phone:610-258-4044
Mailing Address - Fax:908-522-8155
Practice Address - Street 1:1348 BUTLER ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-4758
Practice Address - Country:US
Practice Address - Phone:610-258-4044
Practice Address - Fax:908-522-8155
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT001175002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer