Provider Demographics
NPI:1417155342
Name:FREIJE CHIROPRACTIC CENTER P.C.
Entity Type:Organization
Organization Name:FREIJE CHIROPRACTIC CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:BONIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:FREIJE
Authorized Official - Suffix:
Authorized Official - Credentials:CD
Authorized Official - Phone:701-662-3443
Mailing Address - Street 1:204 COLLEGE DR N
Mailing Address - Street 2:
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-2925
Mailing Address - Country:US
Mailing Address - Phone:701-662-3443
Mailing Address - Fax:701-526-3688
Practice Address - Street 1:204 COLLEGE DR N
Practice Address - Street 2:
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-2925
Practice Address - Country:US
Practice Address - Phone:701-662-3443
Practice Address - Fax:701-526-3688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND532111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND01029001OtherBLE CROSS BLUE SHEILD NUM
ND71108Medicare ID - Type Unspecified
ND01029001OtherBLE CROSS BLUE SHEILD NUM