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Individual

MR. BRIAN M FRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
201 CHESTNUT HILL RD, STAFFORD SPRINGS, CT 06076-4005
(860) 272-2916
(860) 272-2993
Mailing address
PO BOX 307, JOHNSON PROFESSIONAL ASSOCIATES, WILBRAHAM, MA 01095
(508) 595-0531
(508) 829-5367

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000769
CT

Other

Enumeration date
12/27/2005
Last updated
12/10/2007
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