Provider Demographics
NPI:1326878224
Name:FREED, CURTIS LYDELL
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:LYDELL
Last Name:FREED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 BABBITT RD
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-2503
Mailing Address - Country:US
Mailing Address - Phone:216-489-5130
Mailing Address - Fax:
Practice Address - Street 1:780 BABBITT RD
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-2503
Practice Address - Country:US
Practice Address - Phone:216-489-5130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPOS.005394175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist