Individual
GABE FREYALDENHOVEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
2100 W MAIN ST, RUSSELLVILLE, AR 72801-2758
(479) 968-2525
(479) 968-2538
Mailing address
2100 W MAIN ST, RUSSELLVILLE, AR 72801-2758
(479) 968-2525
(479) 968-2538
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2252
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5U687
BLUE CROSS BLUE SHIELD
AR
01
—
662725
HEALTHLINK
AR
01
—
71085780150
QUALCHOICE
AR
01
—
A002
TRICARE
AR
Enumeration date
05/06/2006
Last updated
07/09/2007
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