Individual
BRANDON FRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATP
Contact information
Practice address
900 BLUE RIDGE DR, PROSPER, TX 75078-8696
(209) 304-6058
Mailing address
900 BLUE RIDGE DR, PROSPER, TX 75078-8696
(209) 304-6058
Taxonomy
Speciality
Code
Description
License number
State
225CA2400X
Assistive Technology Practitioner Rehabilitation Counselor
ATP62519
TX
247200000X
Other Technician
Primary
ATP62519
TX
Other
Enumeration date
05/20/2013
Last updated
06/10/2024
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