Kelly Jean Fry, L.M.T.
Individual provider Active NPI Naturopath · Spencer, WV
NPI 1053518399 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1053518399
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Naturopath 175F00000X
- License
- 1999-1318 (WV)
- Practice address
- 142 East Main St.
Spencer, WV 25276 - Phone
- (304) 927-1697
- Fax
- (304) 927-3298
- NPI assigned
- Jun 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1999-1318 | WV | MD | Naturopath |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 1999-1318 | WV | Yes |
Addresses
Primary practice location
142 East Main St.
Spencer, WV 25276
Mailing address
P.O. Box 488
Spencer, WV 25276
Phone (304) 927-1697
Other providers in Spencer, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.