Provider Demographics
NPI:1588302962
Name:FRYE, LARRY BENJAMAN (HAS)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:BENJAMAN
Last Name:FRYE
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5609 SUNSET BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-2763
Mailing Address - Country:US
Mailing Address - Phone:803-490-2920
Mailing Address - Fax:
Practice Address - Street 1:5609 SUNSET BLVD STE D
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2763
Practice Address - Country:US
Practice Address - Phone:803-490-2920
Practice Address - Fax:803-821-9237
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0717237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0717OtherHEARING AID SPECIALIST