Provider Demographics
NPI:1306927041
Name:FRYE, KELLY ANN (DC)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:ANN
Last Name:FRYE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4619 POST RD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-4150
Mailing Address - Country:US
Mailing Address - Phone:401-886-4255
Mailing Address - Fax:401-886-4255
Practice Address - Street 1:4619 POST RD
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-4150
Practice Address - Country:US
Practice Address - Phone:401-886-4255
Practice Address - Fax:401-886-4255
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00389111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIU82326Medicare UPIN
RI007008572Medicare PIN