Healthcare Provider Details

I. General information

NPI: 1184078651
Provider Name (Legal Business Name): FREEDOM THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 04/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 MCNEILL PLZ
WHITEVILLE NC
28472-8602
US

IV. Provider business mailing address

44 MCNEILL PLZ
WHITEVILLE NC
28472-8602
US

V. Phone/Fax

Practice location:
  • Phone: 910-642-0224
  • Fax: 910-642-8537
Mailing address:
  • Phone: 910-642-0224
  • Fax: 910-642-8537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JOE V CALCUTT
Title or Position: CFO
Credential:
Phone: 910-815-3122