Provider Demographics
NPI:1831136639
Name:FRYSZ, JOSEPH ANDREW JR (PT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ANDREW
Last Name:FRYSZ
Suffix:JR
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 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:1455 HAW CREEK CIR
Practice Address - Street 2:SUITE 601
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6574
Practice Address - Country:US
Practice Address - Phone:770-205-1669
Practice Address - Fax:770-205-1671
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT8043225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA65BBDDWMedicare ID - Type Unspecified