Provider Demographics
NPI:1164256582
Name:FREEDOM CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:FREEDOM CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SODERBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:218-301-7226
Mailing Address - Street 1:32809 COUNTY ROAD 326
Mailing Address - Street 2:
Mailing Address - City:BOVEY
Mailing Address - State:MN
Mailing Address - Zip Code:55709-5573
Mailing Address - Country:US
Mailing Address - Phone:218-259-9254
Mailing Address - Fax:
Practice Address - Street 1:104 NE 3RD ST STE 220
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-2881
Practice Address - Country:US
Practice Address - Phone:218-301-7226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty