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NPI Code Detail

MEDICARE: MACKENZIE MARIE FREEMAN PT, DPT

MEDICARE: MACKENZIE MARIE FREEMAN PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist11-06472KS
2225100000XPhysical Therapist2020026180MO

General Provider Information

NPI Number : 1316537491
Entity Type Code : Individual
Provider Name (Legal Business Name) : MACKENZIE MARIE FREEMAN PT, DPT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-238-7217
Fax Number :
Provider Business Practice Location Address
First Line : 220 NW PLATTE VALLEY DR
Second Line :
City : RIVERSIDE
State : MO
Zip : 64150-9793
Country : US
Telephone Number : 816-741-6374
Fax Number : 816-505-3312
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2021
Last Update Date : 01/22/2021

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Directions to “ MACKENZIE MARIE FREEMAN PT, DPT” Practice Location

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