=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013220615
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RYAN MICHAEL FREES D.C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2010
-----------------------------------------------------
Last Update Date | 10/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 320 W 29TH ST STE 100
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21211-2909
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-529-0441
-----------------------------------------------------
Fax | 410-356-9987
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7920 MCDONOGH RD STE 101
-----------------------------------------------------
City | OWINGS MILLS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21117-5249
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-356-9939
-----------------------------------------------------
Fax | 410-356-9987
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 04179
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------