MEDICARE: FRAN FREED PTA

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	225200000X	Physical Therapy Assistant	2028462	TX

General Provider Information

NPI Number	:	1851781140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRAN FREED PTA

Provider Business Mailing Address
First Line	:	7652 W INTERSTATE 20
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76088-8200
Country	:	US
Telephone Number	:	817-658-9553
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 HOLLAND LAKE DR
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-5851
Country	:	US
Telephone Number	:	817-598-0160
Fax Number	:

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

Provider Enumeration Date	:	01/26/2015
Last Update Date	:	01/26/2015

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Directions to “ FRAN FREED PTA” Practice Location

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