Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 1666 | OH |
NPI | 1386689289 |
---|---|
Provider Name | Dr. Adam C Edge |
First Address | Hilliard, OH 43026-0112 |
Second Address | Hilliard, OH 43026-1641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 11/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0818333 | (05) | OH |