Individual
JUANITA FRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3027 SHANNON DR, PUNTA GORDA, FL 33950-2341
(941) 628-6113
(941) 637-1208
Mailing address
3027 SHANNON DR, PUNTA GORDA, FL 33950-2341
(941) 628-6113
(941) 637-1208
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
PTA24977
FL
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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