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General NPI Number Information
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NPI Number | 1356779367
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Entity Type | Organization
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Legal Business Name | FREEDOM MOBILITY, LLC
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Dates
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Enumeration Date | 10/30/2013
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 10515 W MARKHAM ST SOHO CENTRE H6
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City | LITTLE ROCK
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State | AR
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Zip | 72205-2297
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Country | US
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Telephone | 501-413-4855
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Fax |
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Provider Business Mailing Address
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Address Line | 10515 W MARKHAM ST SUITE H6
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City | LITTLE ROCK
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State | AR
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Zip | 72205-2297
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Country | US
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Telephone | 501-413-4855
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Fax | 866-929-2005
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Authorized Official
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Title or Position | CEO
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Name | MR. BRYCE MATTHEW WALZER
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Credential | ATP
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Telephone | 501-413-4855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | AR
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