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General NPI Number Information
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NPI Number | 1265654644
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Entity Type | Individual
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Provider Name | EDWARD LINDSEY FREY DC
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 455 EAST PACES FERRY ROAD 325
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City | ATLANTA
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State | GA
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Zip | 30305
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Country | US
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Telephone | 404-261-7504
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Fax | 404-477-3291
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Provider Business Mailing Address
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Address Line | 2961 CYNTHIA DRIVE
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City | ATLANTA
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State | GA
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Zip | 30319
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Country | US
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Telephone | 404-261-7504
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Fax | 404-477-3291
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2831
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License Number State | GA
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