Healthcare Provider Details

I. General information

NPI: 1215510771
Provider Name (Legal Business Name): FREUND CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 05/03/2021
Certification Date: 05/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

641 E BLITHEDALE AVE STE A
MILL VALLEY CA
94941-1477
US

IV. Provider business mailing address

641 E BLITHEDALE AVE STE A
MILL VALLEY CA
94941-1477
US

V. Phone/Fax

Practice location:
  • Phone: 415-634-8553
  • Fax:
Mailing address:
  • Phone: 415-634-8553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SERAPHINA DOLORES FREUND
Title or Position: OWNER / CHIROPRACTOR
Credential: DC
Phone: 415-634-8553