Individual
DAVID RON FREEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1990 S FRONTAGE RD, SUITE J, VICKSBURG, MS 39180-5232
(601) 738-5714
(855) 753-9454
Mailing address
1990 S FRONTAGE RD, SUITE J, VICKSBURG, MS 39180-5232
(601) 738-5714
(855) 753-9454
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 0703
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000050976
BCBS
MS
01
—
473641ZTAF
MEDICARE
MS
Enumeration date
11/14/2006
Last updated
02/16/2017
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