Individual
LIBERTY FREEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
4715 AIRPORT BLVD STE 310, MOBILE, AL 36608-3181
(251) 344-4212
(251) 344-4302
Mailing address
4715 AIRPORT BLVD STE 310, MOBILE, AL 36608-3181
(251) 344-4212
(251) 344-4302
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1714
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051101973
BCBS NEW
AL
01
—
515-29231
BCBS
AL
01
—
515-42913
BCBS DAPNE, AL. LOCATION
AL
01
—
L223
MEDICARE GROUP #
AL
Enumeration date
06/30/2006
Last updated
09/16/2013
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