Provider Demographics
NPI:1679747919
Name:FREELAND CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:FREELAND CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRYCE
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:FREELAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:8017-763-3974
Mailing Address - Street 1:790 E 700 S
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84015-1204
Mailing Address - Country:US
Mailing Address - Phone:801-776-3974
Mailing Address - Fax:801-776-5332
Practice Address - Street 1:790 E 700 S
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015-1204
Practice Address - Country:US
Practice Address - Phone:801-776-3974
Practice Address - Fax:801-776-5332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT55343551202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty