Provider Demographics
NPI:1922216118
Name:FRYE, DEVIN SCOTT (ATC)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:SCOTT
Last Name:FRYE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8321 NW 106TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-4016
Mailing Address - Country:US
Mailing Address - Phone:405-520-5288
Mailing Address - Fax:405-728-1313
Practice Address - Street 1:8321 NW 106TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-4016
Practice Address - Country:US
Practice Address - Phone:405-520-5288
Practice Address - Fax:405-728-1313
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKAT992255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer