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General NPI Number Information
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NPI Number | 1619430691
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Entity Type | Organization
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Legal Business Name | FREEDOM MEDICAL CARE
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Dates
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Enumeration Date | 04/08/2019
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Last Update Date | 04/08/2019
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Provider Practice Location Address
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Address Line | 5151 E BROADWAY RD STE 105
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City | MESA
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State | AZ
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Zip | 85206-1346
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Country | US
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Telephone | 480-550-6508
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Fax | 480-272-7023
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Provider Business Mailing Address
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Address Line | 6497 S TWILIGHT CT
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City | GILBERT
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State | AZ
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Zip | 85298-8886
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Country | US
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Telephone | 480-550-6508
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VALERIE SHEARMAN GILREATH III
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Credential | DO
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Telephone | 814-490-1677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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