Provider Demographics
NPI:1083789978
Name:FREEHAFER, DON (PT)
Entity Type:Individual
Prefix:MR
First Name:DON
Middle Name:
Last Name:FREEHAFER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7885 BYRON CENTER AVE SW
Mailing Address - Street 2:SUITE A
Mailing Address - City:BYRON CENTER
Mailing Address - State:MI
Mailing Address - Zip Code:49315-8199
Mailing Address - Country:US
Mailing Address - Phone:616-277-1599
Mailing Address - Fax:616-277-1626
Practice Address - Street 1:7885 BYRON CENTER AVE SW
Practice Address - Street 2:SUITE A
Practice Address - City:BYRON CENTER
Practice Address - State:MI
Practice Address - Zip Code:49315-8199
Practice Address - Country:US
Practice Address - Phone:616-277-1599
Practice Address - Fax:616-277-1626
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501003194225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI236697Medicare ID - Type Unspecified