| Doctor Name: | MR. JACK P FRY |
| NPI Number: | 1447510524 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | 2428 |
| Business Practice Address: | 157 Lewis St North Pole, AK - 997057699 |
| Business Phone Number: | 9074884978 |
| Business Fax Number: | 9074884976 |
| Mailing Address: | 113 Mountain Village Dr Apt D, EVANSTON |
| State: | WY |
| Postal Code: | 829302157 |
| Phone Number: | 4352304307 |
| Fax Number: | |
| NPI Enumeration Date: | 05/22/2012 |
| NPI Last Update Date: | 05/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2428 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |