Provider Demographics
NPI:1578153607
Name:FREEDOM THROUGH FUNCTION
Entity Type:Organization
Organization Name:FREEDOM THROUGH FUNCTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:RADOJCICH
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:408-838-5826
Mailing Address - Street 1:33414 OAKLAND ST APT 3
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48335-3571
Mailing Address - Country:US
Mailing Address - Phone:408-838-5826
Mailing Address - Fax:
Practice Address - Street 1:33414 OAKLAND STREET
Practice Address - Street 2:APT 3
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48335-3571
Practice Address - Country:US
Practice Address - Phone:408-838-5826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service