Individual
SHAON D FRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
202 E NIFONG BLVD, SUITE A, COLUMBIA, MO 65203-3759
(573) 777-6955
(573) 777-6957
Mailing address
3301 BERRYWOOD DR, SUITE 204, COLUMBIA, MO 65201-6517
(573) 449-8771
(573) 449-6563
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
109173
MO
Other
Enumeration date
07/19/2006
Last updated
03/18/2015
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