Provider Demographics
NPI:1073037628
Name:FREEMAN, MAUREEN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4216 MCNAMARA PL
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-6912
Mailing Address - Country:US
Mailing Address - Phone:708-790-2113
Mailing Address - Fax:
Practice Address - Street 1:24000 HONDA PKWY
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-8612
Practice Address - Country:US
Practice Address - Phone:937-578-0598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH013353225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist