Provider Demographics
NPI:1801343033
Name:FREEMAN, CARLA (DC)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1130 E MISSOURI AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-2724
Mailing Address - Country:US
Mailing Address - Phone:480-771-1700
Mailing Address - Fax:
Practice Address - Street 1:1130 E MISSOURI AVE STE 402
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2724
Practice Address - Country:US
Practice Address - Phone:480-771-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8564111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor