Provider Demographics
NPI:1538288493
Name:FREEMAN PHYSICAL THERAPY ASSOC
Entity Type:Organization
Organization Name:FREEMAN PHYSICAL THERAPY ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HABERN
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:410-515-1603
Mailing Address - Street 1:2208 OLD EMMORTON RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-8909
Mailing Address - Country:US
Mailing Address - Phone:410-515-1603
Mailing Address - Fax:410-515-1604
Practice Address - Street 1:2208 OLD EMMORTON RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-8909
Practice Address - Country:US
Practice Address - Phone:410-515-1603
Practice Address - Fax:410-515-1604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175L00000XOther Service ProvidersHomeopathGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
J224Medicare ID - Type Unspecified