Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Birthing |
261QB0400X |
| NPI Number | 1932334927 |
| LBN Legal business name | EDENWAY BIRTH CENTER |
| Authorized official | CHARLOTTE RUSSELL - (CLINICAL DIRECTOR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 05/20/2009 |
| Last updated | 05/20/2009 - About 17 years ago |
| Identifiers | n/a |
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