Provider Demographics
NPI:1326560327
Name:EDDS, ELISABETH FARMER (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:FARMER
Last Name:EDDS
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1331 FORESTDALE DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2128
Mailing Address - Country:US
Mailing Address - Phone:704-640-7202
Mailing Address - Fax:
Practice Address - Street 1:290 KRESS VENTURE RD
Practice Address - Street 2:
Practice Address - City:CHINA GROVE
Practice Address - State:NC
Practice Address - Zip Code:28023-8410
Practice Address - Country:US
Practice Address - Phone:704-754-8214
Practice Address - Fax:704-754-8214
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-39902255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer