Healthcare Provider Details

I. General information

NPI: 1700103793
Provider Name (Legal Business Name): THE FREEDOM WELLNESS GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 04/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 ENON ST
BEVERLY MA
01915-1106
US

IV. Provider business mailing address

45 ENON ST
BEVERLY MA
01915-1106
US

V. Phone/Fax

Practice location:
  • Phone: 978-921-1144
  • Fax:
Mailing address:
  • Phone: 978-921-1144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateMA

VIII. Authorized Official

Name: JESSICA PRICE
Title or Position: STUDIO MANAGER
Credential:
Phone: 978-921-1144