Provider Demographics
NPI:1952508624
Name:FRAZIER, JIAME LYNN (ATC)
Entity Type:Individual
Prefix:MRS
First Name:JIAME
Middle Name:LYNN
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 SHADE HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:MILL HALL
Mailing Address - State:PA
Mailing Address - Zip Code:17751-8641
Mailing Address - Country:US
Mailing Address - Phone:570-726-7232
Mailing Address - Fax:
Practice Address - Street 1:103 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-2200
Practice Address - Country:US
Practice Address - Phone:814-342-8304
Practice Address - Fax:814-342-8305
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART002388A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer