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General NPI Number Information
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NPI Number | 1801133046
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Entity Type | Organization
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Legal Business Name | FREEDOM HEALTH CARE MEDICAL COMPANY, PLLC
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Dates
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Enumeration Date | 01/08/2013
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Last Update Date | 03/20/2013
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Provider Practice Location Address
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Address Line | 1097 N ROSARIO ST SUITE 101
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City | MERIDIAN
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State | ID
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Zip | 83642-8004
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Country | US
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Telephone | 208-884-3387
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Fax | 208-895-0250
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Provider Business Mailing Address
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Address Line | 1097 N ROSARIO ST SUITE 101
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City | MERIDIAN
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State | ID
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Zip | 83642-8004
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Country | US
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Telephone | 208-340-7358
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY NELSON
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Credential | M.D.
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Telephone | 801-946-0294
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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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