Individual
AUTUMN FRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 PEGASUS COURT, WINCHESTER, VA 22602-4596
(800) 805-6989
Mailing address
500 PEGASUS CT STE 500, WINCHESTER, VA 22602-4596
(304) 702-7900
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
36115
WV
Other
Enumeration date
04/24/2022
Last updated
04/24/2022
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