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General NPI Number Information
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NPI Number | 1851334197
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Entity Type | Organization
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Legal Business Name | FRIES FAMILY CARE CENTER PC
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 07/28/2008
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Provider Practice Location Address
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Address Line | 109 CARROL DR
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City | FRIES
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State | VA
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Zip | 24330-4532
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Country | US
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Telephone | 276-744-3660
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Fax | 276-744-3843
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Provider Business Mailing Address
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Address Line | PO BOX 453
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City | FRIES
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State | VA
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Zip | 24330-0453
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Country | US
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Telephone | 276-744-3660
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Fax | 276-744-3843
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | SHERRIE WILLIAMS
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Credential | RN, CPC
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Telephone | 276-744-3660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | VA
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