Healthcare Provider Details
I. General information
NPI: 1285100644
Provider Name (Legal Business Name): DANIEL FREEMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/23/2018
Last Update Date: 10/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
510 W ANNANDALE RD STE 300
FALLS CHURCH VA
22046-4226
US
IV. Provider business mailing address
510 W ANNANDALE RD STE 300
FALLS CHURCH VA
22046-4226
US
V. Phone/Fax
- Phone: 703-600-8208
- Fax: 703-437-2404
- Phone: 703-600-8208
- Fax: 703-437-2404
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 0104-557523 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: