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Organization
EDWARDS CHIROPRACTIC CLINIC P.C
Active
Organization
EDWARDS CHIROPRACTIC CLINIC P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARTH L EDWARDS MD,DC,MHS,DACBN,CCN (OWNER)
(708) 748-5600
Entity
Organization
Contact information
Practice address
22111 GOVERNORS HWY, RICHTON PARK, IL 60471-1249
(708) 747-5600
(708) 748-5635
Mailing address
1824 HEATHER HILL CRES, FLOSSMOOR, IL 60422-2000
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013922673
NPI INDIVIDUAL
IL
01
—
1645747
BCBS PROVIDER
IL
Enumeration date
04/20/2007
Last updated
03/26/2008
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