Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 1082 | MS |
N | 111N00000X | Chiropractor | 1364 | LA |
N | 111NS0005X | Chiropractic Sports Physician | 1364 | LA |
NPI | 1083750400 |
---|---|
Provider Name | Dr. David Christopher Edwards |
First Address | Metairie, LA 70002-5525 |
Second Address | Metairie, LA 70002-5525 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V05380 | (02) | LA |