Individual
SUSAN J FRASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1263 S GEORGE ST, CHARLES TOWN, WV 25414-4384
(304) 725-6575
Mailing address
62 BOULDIN RD, CHARLES TOWN, WV 25414-5668
(315) 212-3637
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002052
WV
Other
Enumeration date
11/22/2023
Last updated
11/22/2023
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