Provider Demographics
NPI:1104659770
Name:FREEMAN, KRISTOPHER CALEB (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:KRISTOPHER
Middle Name:CALEB
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 COVINGTON WAY APT 312
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-7158
Mailing Address - Country:US
Mailing Address - Phone:501-278-7680
Mailing Address - Fax:
Practice Address - Street 1:10 VIEW POINT CV
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-1711
Practice Address - Country:US
Practice Address - Phone:501-289-5609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR5522225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist