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General NPI Number Information
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NPI Number | 1285507558
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Entity Type | Organization
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Legal Business Name | MICHELLE LEE FREEZE
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Dates
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Enumeration Date | 09/24/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 5520 OLD BULLARD RD STE 114
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City | TYLER
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State | TX
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Zip | 75703-4361
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Country | US
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Telephone | 903-309-3820
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Fax |
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Provider Business Mailing Address
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Address Line | 2309 CAMRYN LN
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City | MABANK
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State | TX
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Zip | 75147-1339
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Country | US
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Telephone | 903-941-7351
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. MICHELLE FREEZE
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Credential | DC
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Telephone | 903-941-7351
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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 |
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License Number State |
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