Provider Demographics
NPI:1477925212
Name:JRFREEMAN LLC
Entity Type:Organization
Organization Name:JRFREEMAN LLC
Other - Org Name:FREEMAN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-531-8674
Mailing Address - Street 1:6521 HIGHWAY 69 S
Mailing Address - Street 2:SUITE N
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-3964
Mailing Address - Country:US
Mailing Address - Phone:205-345-5035
Mailing Address - Fax:205-345-5034
Practice Address - Street 1:6521 HIGHWAY 69 S
Practice Address - Street 2:SUITE N
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-3964
Practice Address - Country:US
Practice Address - Phone:205-345-5035
Practice Address - Fax:205-345-5034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2441111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1366847089Medicare NSC