Provider Demographics
NPI:1326213430
Name:FRYE CHIROPRACTIC CENTER P.C.
Entity Type:Organization
Organization Name:FRYE CHIROPRACTIC CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:JOANN
Authorized Official - Last Name:FRYE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-341-2505
Mailing Address - Street 1:197 CASTLE SHANNON BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-2268
Mailing Address - Country:US
Mailing Address - Phone:412-341-2505
Mailing Address - Fax:412-341-0402
Practice Address - Street 1:197 CASTLE SHANNON BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-2268
Practice Address - Country:US
Practice Address - Phone:412-341-2505
Practice Address - Fax:412-341-0402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004095L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAUO2668Medicare UPIN