Provider Demographics
NPI:1306149448
Name:JON FRECKLETON DO, PLLC
Entity type:Organization
Organization Name:JON FRECKLETON DO, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/BOOKKEEPER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LEROSS
Authorized Official - Last Name:FRECKLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-871-1300
Mailing Address - Street 1:PO BOX 775549
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80477-5549
Mailing Address - Country:US
Mailing Address - Phone:970-871-1300
Mailing Address - Fax:970-879-6295
Practice Address - Street 1:350 OAK STREET
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80477-5549
Practice Address - Country:US
Practice Address - Phone:970-871-1300
Practice Address - Fax:970-879-6295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty