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Individual

MRS. TRACY MAE FRIED

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
31 MIDDLE ST, LYNDONVILLE, VT 05851-1346
(802) 626-4224
(802) 626-5042
Mailing address
PO BOX 1346, LYNDONVILLE, VT 05851-1346
(802) 626-4224
(802) 626-5042

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
040-0003237
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1011488
VT
01
68576
BCBS
VT
Enumeration date
06/26/2006
Last updated
07/08/2007
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