Individual
REBECCA LYNN FREEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
550 E 1400 N STE P, LOGAN, UT 84341-2450
(435) 752-2020
(435) 752-5475
Mailing address
955 W SOUTHERN AVE, STE 101, MESA, AZ 85210-4903
(480) 961-1702
(480) 893-8172
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1752
AZ
152W00000X
Optometrist
2008020588
MO
152W00000X
Optometrist
9291202-9934
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1752
STATE LICENSE
AZ
01
—
2008020588
MISSOURI STATE LICENSE
MO
01
—
9291202-9934
UTAH STATE PROFESSIONAL LICENSE
UT
Enumeration date
08/04/2008
Last updated
04/25/2019
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