Individual
EDNA MARIE JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1857 N REYNOLDS RD, TOLEDO, OH 43615-3537
(419) 537-9877
(419) 537-9878
Mailing address
PO BOX 2969, TOLEDO, OH 43606-0969
(419) 537-9877
(419) 537-9878
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36-00-2601-J
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0765908
—
OH
Enumeration date
10/06/2005
Last updated
01/30/2013
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