Provider Demographics
NPI:1679780027
Name:FRAZIER, JOYCE FAYE (P T)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:FAYE
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 STONE AVE
Mailing Address - Street 2:BOX 604
Mailing Address - City:WHITESBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41858-7645
Mailing Address - Country:US
Mailing Address - Phone:606-633-5203
Mailing Address - Fax:606-633-1648
Practice Address - Street 1:143 STONE AVE
Practice Address - Street 2:BOX 604
Practice Address - City:WHITESBURG
Practice Address - State:KY
Practice Address - Zip Code:41858-7645
Practice Address - Country:US
Practice Address - Phone:606-633-5203
Practice Address - Fax:606-633-1648
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004217225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist