Provider Demographics
NPI:1942873609
Name:FREEDOM FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:FREEDOM FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO/ PROVIDER/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MELENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-419-8981
Mailing Address - Street 1:7215 S POWER RD STE B103
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6336
Mailing Address - Country:US
Mailing Address - Phone:760-419-8981
Mailing Address - Fax:
Practice Address - Street 1:7215 S POWER RD STE B103
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-6336
Practice Address - Country:US
Practice Address - Phone:760-419-8981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty