Provider Demographics
NPI:1154877512
Name:FREESE, ABIGAIL JANE (DPT)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:JANE
Last Name:FREESE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:JANE
Other - Last Name:KETTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:735 HUMMINGBIRD DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-7455
Mailing Address - Country:US
Mailing Address - Phone:765-914-7810
Mailing Address - Fax:
Practice Address - Street 1:3001 SPRING FOREST RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-2815
Practice Address - Country:US
Practice Address - Phone:919-424-5080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05010562A225100000X, 2251C2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251C2600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistCardiopulmonary
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN183380037Medicare PIN