Provider Demographics
NPI:1285934984
Name:RICHARD J. FREESMEIER, D.C., P.A.
Entity type:Organization
Organization Name:RICHARD J. FREESMEIER, D.C., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:FREESMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-878-8242
Mailing Address - Street 1:2538 CAPITAL MEDICAL BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4424
Mailing Address - Country:US
Mailing Address - Phone:850-878-8242
Mailing Address - Fax:850-878-7129
Practice Address - Street 1:2538 CAPITAL MEDICAL BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4424
Practice Address - Country:US
Practice Address - Phone:850-878-8242
Practice Address - Fax:850-878-7129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003407111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL050127100Medicaid
FL050127100Medicaid
T55869Medicare UPIN