Provider Demographics
NPI:1427329945
Name:FREECE, KATELYN ANN (MS, ATC)
Entity type:Individual
Prefix:MISS
First Name:KATELYN
Middle Name:ANN
Last Name:FREECE
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 GLENBURN PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1821
Mailing Address - Country:US
Mailing Address - Phone:614-203-0538
Mailing Address - Fax:
Practice Address - Street 1:1313 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3120
Practice Address - Country:US
Practice Address - Phone:614-839-2132
Practice Address - Fax:614-790-1038
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT00.4772255A2300X
IL096.0032872255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer