Provider Demographics
NPI:1912576992
Name:EDWARDS CHIROPRACTIC CENTER LLC
Entity Type:Organization
Organization Name:EDWARDS CHIROPRACTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:MCGRAW
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:225-635-9555
Mailing Address - Street 1:205 HURRICANE RD
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-5228
Mailing Address - Country:US
Mailing Address - Phone:225-635-9555
Mailing Address - Fax:225-635-9572
Practice Address - Street 1:205 HURRICANE RD
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-5228
Practice Address - Country:US
Practice Address - Phone:225-635-9555
Practice Address - Fax:225-635-9572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty