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NPI Profile for KENNETH L EDWARDS in EASTANOLLEE, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Optician |
156FX1800X | 96[5] | Optician |
| NPI # | 1720851769 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 11/01/2023 | |
| Last updated | 11/01/2023 - About 3 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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KENNETH L EDWARDS
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KENNETH L EDWARDS