Basic Information
| Provider Information | |||||||||
| NPI: | 1639662380 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FREEMAN | ||||||||
| FirstName: | CASEY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 732031 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753732031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8664296045 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6767 29TH ST FL 3 | ||||||||
| Address2: | |||||||||
| City: | GREELEY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806345474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9706242414 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2018 | ||||||||
| LastUpdateDate: | 09/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 94-09546 | KS | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208100000X | DR.0068149 | CO | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.