Most Relevant Information
Provider Data
| NPI Number: | 1003494899 |
| Provider Name: | REBECCA LYNN FRYER GORDON DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/01/2021 |
| Last Updated: | 07/23/2024 |
Provider Practice Location
3800 S NATIONAL AVE STE 700
SPRINGFIELD
MO
658075279
Practice Location Phone/Fax
| Phone: | 4172698817 |
| Fax: | 4172698744 |
Provider Mailing Location
600 BLUES LAKE PKWY
ROLLA
MO
654018022
Provider Mailing Phone/Fax
| Phone: | 5733648822 |
| Fax: | 5732022402 |