Healthcare Provider Details

I. General information

NPI: 1992904270
Provider Name (Legal Business Name): CARRIE PARRIS FRAME DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARRIE PARRIE GOSSELINK DPM

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 KENTON DR STE 100
CHARLESTON WV
25311-1256
US

IV. Provider business mailing address

1 KENTON DR STE 100
CHARLESTON WV
25311-1256
US

V. Phone/Fax

Practice location:
  • Phone: 304-306-8990
  • Fax: 877-471-5976
Mailing address:
  • Phone: 304-306-8990
  • Fax: 877-471-5976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number10409
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: