Provider Demographics
NPI:1356646533
Name:FREUDENTHAL, MATTHEW CLAY (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:CLAY
Last Name:FREUDENTHAL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7514 42ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55427-1225
Mailing Address - Country:US
Mailing Address - Phone:763-746-1244
Mailing Address - Fax:763-746-1246
Practice Address - Street 1:7514 42ND AVE N
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55427-1225
Practice Address - Country:US
Practice Address - Phone:763-746-1244
Practice Address - Fax:763-746-1246
Is Sole Proprietor?:No
Enumeration Date:2011-01-19
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5452111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor