Provider Demographics
NPI:1710267760
Name:FREESE, ZAKERY JON (PHARMD)
Entity Type:Individual
Prefix:
First Name:ZAKERY
Middle Name:JON
Last Name:FREESE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 ROUNDSTONE WAY APT 206
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-2422
Mailing Address - Country:US
Mailing Address - Phone:724-272-4981
Mailing Address - Fax:
Practice Address - Street 1:3534 MOUNT HOLLY HUNTERSVILLE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-8644
Practice Address - Country:US
Practice Address - Phone:704-399-5823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22072183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist