Individual
DR. BRADLEY DALLAS FREESTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
6255330-8908
UT
152W00000X
Optometrist
Primary
OPT002834
AZ
152WL0500X
Low Vision Rehabilitation Optometrist
6255330-9934
UT
152WV0400X
Vision Therapy Optometrist
6255330-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
324761
—
AZ
05
—
D7028
—
UT
Enumeration date
07/28/2006
Last updated
03/17/2025
Update your record
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