Provider Demographics
NPI:1063820140
Name:FREEMAN, CHRISTOPHER
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1391 COLLIER RD NW APT 3108
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-7445
Mailing Address - Country:US
Mailing Address - Phone:678-427-7925
Mailing Address - Fax:
Practice Address - Street 1:1551 JOHNSON FERRY RD
Practice Address - Street 2:GENESIS REHAB SERVICES
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-6438
Practice Address - Country:US
Practice Address - Phone:770-509-0919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-01
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOTA001749224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant