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General NPI Number Information
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NPI Number | 1417238502
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Entity Type | Organization
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Legal Business Name | FRIE OPTOMETRY LLC
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Dates
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Enumeration Date | 09/01/2011
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 3063 MEADOWLARK LANE SUITE 10
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City | ALTOONA
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State | WI
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Zip | 54720
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Country | US
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Telephone | 715-514-1289
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Fax | 715-514-1290
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Provider Business Mailing Address
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Address Line | 3063 MEADOWLARK LANE SUITE 10
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City | ALTOONA
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State | WI
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Zip | 54720
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Country | US
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Telephone | 715-514-1289
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Fax | 715-514-1290
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Authorized Official
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Title or Position | DOCTOR
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Name | NATALEE Z FRIE
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Credential | OS
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Telephone | 715-514-1289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2951-035
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License Number State | WI
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