Provider Demographics
NPI:1518940378
Name:FREED, WILLIAM LAWRENCE (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LAWRENCE
Last Name:FREED
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6515 MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-1354
Mailing Address - Country:US
Mailing Address - Phone:203-261-3144
Mailing Address - Fax:203-261-7988
Practice Address - Street 1:6515 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-1354
Practice Address - Country:US
Practice Address - Phone:203-261-3144
Practice Address - Fax:203-261-7988
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT558111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT05000558CT01OtherANTHEM ID #