Healthcare Provider Details

I. General information

NPI: 1912018532
Provider Name (Legal Business Name): JENNIFER CHRISTINE FREES D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 ALEXANDRIA PIKE SUITE E
COLD SPRING KY
41076-3530
US

IV. Provider business mailing address

4200 ALEXANDRIA PIKE SUITE E
COLD SPRING KY
41076-3530
US

V. Phone/Fax

Practice location:
  • Phone: 859-442-7200
  • Fax: 859-442-7555
Mailing address:
  • Phone: 859-442-7200
  • Fax: 859-442-7555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5009
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: