Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 000998 | CT |
NPI | 1750470027 |
---|---|
Provider Name | Dr. Edward Geddis |
First Address | New Milford, CT 06776-3485 |
Second Address | New Milford, CT 06776-3485 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 18/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U38941 | (02) | CT |