Provider Demographics
NPI:1023070471
Name:FREIHAUT, MARGARET MARIE (DC)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:MARIE
Last Name:FREIHAUT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 BILTMORE DR STE 407
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-4641
Mailing Address - Country:US
Mailing Address - Phone:636-305-3400
Mailing Address - Fax:636-305-3480
Practice Address - Street 1:400 BILTMORE DR STE 407
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-4641
Practice Address - Country:US
Practice Address - Phone:636-305-3400
Practice Address - Fax:636-305-3480
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO4401111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOT43365Medicare UPIN
MO000030828Medicare ID - Type Unspecified