Provider Demographics
NPI:1245686484
Name:FRIIS, BRIAN B (DPM)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:B
Last Name:FRIIS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 20970
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-7020
Mailing Address - Country:US
Mailing Address - Phone:307-773-8237
Mailing Address - Fax:307-773-8013
Practice Address - Street 1:2301 HOUSE AVE STE 207
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3178
Practice Address - Country:US
Practice Address - Phone:307-778-1849
Practice Address - Fax:307-778-4995
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY161213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist