Individual
MRS. PATRICE A. FREESTONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
H.I.S.
Contact information
Practice address
406 LEGACY PLZ W, LA PORTE, IN 46350-5296
(219) 324-6608
(219) 324-6058
Mailing address
406 LEGACY PLZ W, LA PORTE, IN 46350-5296
(219) 324-6608
(219) 324-6058
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
17001089A
IN
Other
Enumeration date
08/16/2006
Last updated
07/09/2007
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