Individual
MINDY FRYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 ALLAN ST, MYRTLE CREEK, OR 97457-9437
(541) 643-0319
Mailing address
130 ALLAN ST, MYRTLE CREEK, OR 97457-9437
(541) 643-0319
Taxonomy
Speciality
Code
Description
License number
State
163WR0400X
Rehabilitation Registered Nurse
Primary
200141599
OR
163WW0000X
Wound Care Registered Nurse
200141599
OR
Other
Enumeration date
03/12/2015
Last updated
03/12/2015
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