Individual
MS. KACIE ANN FREEBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
4045 WEST ROYAL DRIVE, TRAVERSE CITY, MI 49684-8965
(231) 935-0900
(231) 935-0308
Mailing address
4045 WEST ROYAL DRIVE, TRAVERSE CITY, MI 49684-8965
(231) 935-0900
(231) 935-0308
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5601005684
MI
Other
Enumeration date
11/12/2009
Last updated
05/03/2012
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