Provider Demographics
NPI:1821406877
Name:TERRY A. FRYE PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:TERRY A. FRYE PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PT
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FRYE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:509-430-9669
Mailing Address - Street 1:PO BOX 4015
Mailing Address - Street 2:
Mailing Address - City:WEST RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99353-4000
Mailing Address - Country:US
Mailing Address - Phone:509-430-9669
Mailing Address - Fax:509-461-8088
Practice Address - Street 1:303 BRADLEY BLVD STE 204
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4497
Practice Address - Country:US
Practice Address - Phone:509-430-9669
Practice Address - Fax:509-461-8088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00007959261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy