Provider Demographics
NPI:1306431531
Name:FREEMAN, CHRISTOPHER (MACOM, LAC, DIPLOM)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MACOM, LAC, DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 SANDY SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-9020
Mailing Address - Country:US
Mailing Address - Phone:503-939-2050
Mailing Address - Fax:
Practice Address - Street 1:3313 PACKERLAND DR STE D
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-6811
Practice Address - Country:US
Practice Address - Phone:920-241-3719
Practice Address - Fax:920-632-6317
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1018-55171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist