Individual
KENNETH C. FRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
7602 LYNES CT, SAVANNAH, GA 31406-6423
(912) 272-6121
Mailing address
PO BOX 14116, SAVANNAH, GA 31416-1116
(912) 691-1222
(912) 691-1277
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
GAOPT001492
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
974157681A
—
GA
Enumeration date
11/05/2006
Last updated
03/01/2019
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