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General NPI Number Information
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NPI Number | 1609267913
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Entity Type | Organization
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Legal Business Name | FREEDOM PHYSICAL THERAPY AND TRAINING CENTER PA
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Dates
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Enumeration Date | 02/09/2015
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 7740 HEDGE LANE TER
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City | SHAWNEE
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State | KS
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Zip | 66227-3017
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Country | US
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Telephone | 913-745-7537
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Fax |
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Provider Business Mailing Address
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Address Line | 7740 HEDGE LANE TER
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City | SHAWNEE
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State | KS
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Zip | 66227-3017
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DPT
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Name | DR. DON CLYDE DEQUINE JR.
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Credential | PT
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Telephone | 408-489-3836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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