MEDICARE: DR. WHITNEY FREEMAN D.O.

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	2000146011	MO

General Provider Information

NPI Number	:	1629259734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WHITNEY FREEMAN D.O.

Provider Business Mailing Address
First Line	:	PO BOX 494
Second Line	:	106 N CONNECTICUT
City	:	KING CITY
State	:	MO
Zip	:	64463-0494
Country	:	US
Telephone Number	:	660-535-4904
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 N CONNECTICUT
Second Line	:
City	:	KING CITY
State	:	MO
Zip	:	64463-0494
Country	:	US
Telephone Number	:	660-535-4904
Fax Number	:

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

Provider Enumeration Date	:	11/16/2007
Last Update Date	:	11/16/2007

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