Individual
MATTHEW FRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6001
Mailing address
405 W GRAND AVE, DAYTON, OH 45405-7538
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34.016320
OH
Other
Enumeration date
04/10/2021
Last updated
10/16/2024
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