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Individual

DUANE FREEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAC- 20374

Contact information

Practice address
11020 N TATUM BLVD STE 100, PHOENIX, AZ 85028-6072
(928) 228-5733
Mailing address
11020 N TATUM BLVD STE 100, PHOENIX, AZ 85028-6072
(928) 228-5733

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-20374
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LAC-20374
LAC
AZ
Enumeration date
12/27/2022
Last updated
12/27/2022
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