Individual
DR. RENITA CHARLENE FROST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
7840 E ST ROUTE HWY 69, SUITE A-5A, PRESCOTT VALLEY, AZ 86314-2274
(928) 775-9393
Mailing address
616 N ZUNI TRL, DEWEY, AZ 86327-5638
(928) 533-2671
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
521
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z70680
MEDICARE PTAN
AZ
Enumeration date
11/02/2006
Last updated
11/24/2020
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