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Individual

MRS. TOMOE MARUTA FRYE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPTA

Contact information

Practice address
5610 BERMUDA ROAD, STE. A, STONE MOUNTAIN, GA 30087
(678) 684-3872
Mailing address
1995 MEYERS DR, LAWRENCEVILLE, GA 30045-3443
(479) 466-5882

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
005059
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
150477721
AR
Enumeration date
07/06/2006
Last updated
10/12/2023
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