Healthcare Provider Details

I. General information

NPI: 1982930905
Provider Name (Legal Business Name): FREEDOM HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2009
Last Update Date: 10/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 N ELAM AVE FL 2
GREENSBORO NC
27403-1157
US

IV. Provider business mailing address

509 N ELAM AVE FL 2
GREENSBORO NC
27403-1157
US

V. Phone/Fax

Practice location:
  • Phone: 336-274-1114
  • Fax: 336-232-5325
Mailing address:
  • Phone: 336-274-1114
  • Fax: 336-232-5325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. WILDA M YOUNG
Title or Position: PRESIDENT
Credential: PT
Phone: 336-274-1114