Provider Demographics
NPI:1598802498
Name:FREED CHIROPRACTIC CLINIC, LLC
Entity Type:Organization
Organization Name:FREED CHIROPRACTIC CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:F
Authorized Official - Last Name:FREED
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-589-2225
Mailing Address - Street 1:PO BOX 1255
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-1255
Mailing Address - Country:US
Mailing Address - Phone:740-589-2225
Mailing Address - Fax:740-589-2220
Practice Address - Street 1:14 W STIMSON AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2647
Practice Address - Country:US
Practice Address - Phone:740-589-2225
Practice Address - Fax:740-589-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHFR9358421Medicare ID - Type UnspecifiedMEDICARE GROUP #