Provider Demographics
NPI:1396031175
Name:EDGECOMBE, ANTHONY STEVEN (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:STEVEN
Last Name:EDGECOMBE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 DARLINGTON AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-2056
Mailing Address - Country:US
Mailing Address - Phone:765-359-3330
Mailing Address - Fax:
Practice Address - Street 1:1408 DARLINGTON AVE
Practice Address - Street 2:SUITE G
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-2056
Practice Address - Country:US
Practice Address - Phone:765-359-3330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002570A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor