Provider Demographics
NPI:1265690432
Name:FRITSCH, AMBER RENEE (OD)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:RENEE
Last Name:FRITSCH
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 1:667 SOUTH MT. JULIET RD
Mailing Address - Street 2:
Mailing Address - City:MT. JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-6319
Mailing Address - Country:US
Mailing Address - Phone:615-758-2344
Mailing Address - Fax:615-758-8868
Practice Address - Street 1:667 SOUTH MT. JULIET RD
Practice Address - Street 2:
Practice Address - City:MT. JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-6319
Practice Address - Country:US
Practice Address - Phone:615-758-2344
Practice Address - Fax:615-758-8868
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-24
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2728152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist