Provider Demographics
NPI:1972516623
Name:FRYER, CARL L (DC)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:L
Last Name:FRYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:CARL
Other - Middle Name:L
Other - Last Name:FRYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 984
Mailing Address - Street 2:1424E 72 BY PASS NE
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29648-0984
Mailing Address - Country:US
Mailing Address - Phone:864-223-6500
Mailing Address - Fax:864-229-5489
Practice Address - Street 1:1424E 72 BY PASS NE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-0000
Practice Address - Country:US
Practice Address - Phone:864-223-6500
Practice Address - Fax:864-229-5489
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC864111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor