Healthcare Provider Details

I. General information

NPI: 1073511366
Provider Name (Legal Business Name): CATHY L FRIER O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 12/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E HOSPITAL RD
EL DORADO SPRINGS MO
64744-2316
US

IV. Provider business mailing address

701 E HOSPITAL RD
EL DORADO SPRINGS MO
64744-2316
US

V. Phone/Fax

Practice location:
  • Phone: 417-876-6052
  • Fax: 417-876-3352
Mailing address:
  • Phone: 417-876-6052
  • Fax: 417-876-3352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberT02316
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: