MEDICARE: DR. DAVID H. FREE D.C.

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
1	111N00000X	Chiropractor	334676-1202	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	107001713101	OTHER	UT	INTERMOUNTAIN HEALTH
2	44-00107	OTHER	UT	UNITED HEALTH CARE
3	870622872	OTHER	UT	AETNA
4	870622872 0002	OTHER	UT	CIGNA

General Provider Information

NPI Number	:	1326045279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID H. FREE D.C.

Provider Business Mailing Address
First Line	:	28 N 100 E
Second Line	:
City	:	PLEASANT GROVE
State	:	UT
Zip	:	84062-2302
Country	:	US
Telephone Number	:	801-796-7075
Fax Number	:	801-796-7085

Provider Business Practice Location Address
First Line	:	28 N 100 E
Second Line	:
City	:	PLEASANT GROVE
State	:	UT
Zip	:	84062-2302
Country	:	US
Telephone Number	:	801-796-7075
Fax Number	:	801-796-7085

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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