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Individual

DEREK FRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
A.T.C.

Contact information

Practice address
200 LIVINGSTON DR, GRANVILLE, OH 43023
(740) 587-6577
Mailing address
100 W COLLEGE ST, GRANVILLE, OH 43023-1100
(740) 587-6577

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003540
OH

Other

Enumeration date
12/30/2014
Last updated
12/30/2014
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