Provider Demographics
NPI:1083783377
Name:FREEDOM CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:FREEDOM CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR MEMBER PLLC
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:FROEHLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-832-4499
Mailing Address - Street 1:679 ORANGEBURG RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-8914
Mailing Address - Country:US
Mailing Address - Phone:843-832-4499
Mailing Address - Fax:843-832-4978
Practice Address - Street 1:679 ORANGEBURG RD
Practice Address - Street 2:SUITE A
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-8914
Practice Address - Country:US
Practice Address - Phone:843-832-4499
Practice Address - Fax:843-832-4978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3439111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty