Provider Demographics
NPI:1104812908
Name:FREED, ERIC F (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:F
Last Name:FREED
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 CAMPBELL DR
Mailing Address - Street 2:
Mailing Address - City:BELPRE
Mailing Address - State:OH
Mailing Address - Zip Code:45714-1217
Mailing Address - Country:US
Mailing Address - Phone:304-481-5619
Mailing Address - Fax:
Practice Address - Street 1:14 W STIMSON AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2647
Practice Address - Country:US
Practice Address - Phone:740-589-2225
Practice Address - Fax:740-589-2220
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2268095/0690793Medicaid
OH2268095/0690793Medicaid