Provider Demographics
NPI:1134141542
Name:FRYE, SARAH D (OD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:D
Last Name:FRYE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2170 E. CLEVELAND
Mailing Address - Street 2:
Mailing Address - City:MONETT
Mailing Address - State:MO
Mailing Address - Zip Code:65708
Mailing Address - Country:US
Mailing Address - Phone:417-235-0853
Mailing Address - Fax:417-235-0856
Practice Address - Street 1:1265 E PRIMROSE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804
Practice Address - Country:US
Practice Address - Phone:417-235-0853
Practice Address - Fax:417-235-0856
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006017273152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist