Provider Demographics
NPI:1578229340
Name:FREEMAN, DARO THERON (MBA)
Entity Type:Individual
Prefix:MR
First Name:DARO
Middle Name:THERON
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 BARDAVILLE DR # 7C
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48906-5809
Mailing Address - Country:US
Mailing Address - Phone:517-721-1520
Mailing Address - Fax:
Practice Address - Street 1:3310 BARDAVILLE DR # 7C
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48906-5809
Practice Address - Country:US
Practice Address - Phone:517-721-1520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIEJV4026347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle