Individual
CHARLES G FRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
1411 LINCOLNWAY W, MISHAWAKA, IN 46544-1626
(574) 259-5666
(574) 537-2652
Mailing address
PO BOX 809, GOSHEN, IN 46527-0809
(574) 533-1234
(574) 537-2652
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/01/2011
Last updated
08/01/2011
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