Provider Demographics
NPI:1851333595
Name:EDGERTON, LEE ANNA (DC)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:ANNA
Last Name:EDGERTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 US 221 HWY N
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-7616
Mailing Address - Country:US
Mailing Address - Phone:828-286-8970
Mailing Address - Fax:828-286-9087
Practice Address - Street 1:175 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-2501
Practice Address - Country:US
Practice Address - Phone:828-286-8970
Practice Address - Fax:828-286-9087
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2576111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0833VOtherBCBS
NC890833VMedicaid
NC0833VOtherBCBS