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General NPI Number Information
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NPI Number | 1659542587
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Entity Type | Individual
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Provider Name | CHAD FREITAG
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Gender | Male
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 03/19/2008
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Provider Practice Location Address
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Address Line | 322 NUWAY CIR
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City | LENOIR
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State | NC
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Zip | 28645-3656
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Country | US
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Telephone | 828-754-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 3528 MULL CREEK LN
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City | CLAREMONT
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State | NC
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Zip | 28610-9779
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Country | US
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Telephone | 828-459-9576
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Fax |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2636
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License Number State | NC
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