Provider Demographics
NPI:1689446684
Name:FREYBLER, ADDISON RICHARD
Entity Type:Individual
Prefix:
First Name:ADDISON
Middle Name:RICHARD
Last Name:FREYBLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 17TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-5453
Mailing Address - Country:US
Mailing Address - Phone:608-738-9591
Mailing Address - Fax:
Practice Address - Street 1:506 N SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-5737
Practice Address - Country:US
Practice Address - Phone:605-334-8073
Practice Address - Fax:605-334-3752
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1474111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor