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General NPI Number Information
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NPI Number | 1184583999
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Entity Type | Organization
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Legal Business Name | FREEDOM INTEGRATED MEDICINE LLC
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Dates
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Enumeration Date | 01/17/2026
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Last Update Date | 01/17/2026
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Provider Practice Location Address
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Address Line | 4775 W DAYBREAK PKWY STE 102
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City | SOUTH JORDAN
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State | UT
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Zip | 84009-5139
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Country | US
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Telephone | 801-571-1338
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Fax | 801-516-4438
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Provider Business Mailing Address
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Address Line | 4775 W DAYBREAK PKWY STE 102
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City | SOUTH JORDAN
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State | UT
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Zip | 84009-5139
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Country | US
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Telephone | 801-571-1338
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Fax | 801-516-4438
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN J CHALK
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Credential | DC
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Telephone | 801-502-6249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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