Provider Demographics
NPI:1871256297
Name:FREEMAN, SPENCER DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:DAVID
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 BELLERIVE DR APT 215
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-8820
Mailing Address - Country:US
Mailing Address - Phone:248-330-8530
Mailing Address - Fax:
Practice Address - Street 1:1776 FOWLER ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4833
Practice Address - Country:US
Practice Address - Phone:509-396-3980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61218924111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor