Provider Demographics
NPI:1649656141
Name:FRYE, LAURA (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:FRYE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 MASSACHUSETTS AVE STE 214
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4088
Mailing Address - Country:US
Mailing Address - Phone:503-678-9806
Mailing Address - Fax:
Practice Address - Street 1:254 ESSEX ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-1944
Practice Address - Country:US
Practice Address - Phone:978-338-1568
Practice Address - Fax:978-338-5685
Is Sole Proprietor?:No
Enumeration Date:2015-08-06
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21834208100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation