Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | CH1289 | MA |
NPI | 1437229853 |
---|---|
Provider Name | Dr. Steven D Edmonds |
First Address | Dedham, MA 02026-3320 |
Second Address | Boston, MA 02116-3952 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 08/07/2007 |