Individual
MARY FRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1215 E MICHIGAN AVE, LANSING, MI 48912-1811
(517) 364-2223
Mailing address
PO BOX 634280, CINCINNATI, OH 45263-0041
(517) 337-0957
(517) 336-9122
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003035
MI
Other
Enumeration date
03/07/2007
Last updated
03/14/2008
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