Provider Demographics
NPI:1912319971
Name:FRYDMAN, LARRY G (DC)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:G
Last Name:FRYDMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2637 E ATLANTIC BLVD
Mailing Address - Street 2:#145
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-4939
Mailing Address - Country:US
Mailing Address - Phone:786-252-3397
Mailing Address - Fax:800-298-7337
Practice Address - Street 1:2745 E ATLANTIC BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-4952
Practice Address - Country:US
Practice Address - Phone:786-252-3397
Practice Address - Fax:800-298-7337
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10780111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor