Organization
CAROL E. EDWARDS
Active
Other names
All About Braces
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL ELIZABETH EDWARDS (OWNER)
(505) 935-4357
Entity
Organization
Contact information
Practice address
1423 N MAIN ST, CLOVIS, NM 88101-4747
(575) 935-4357
(575) 935-4358
Mailing address
1423 N MAIN ST, CLOVIS, NM 88101-4747
(575) 935-4357
(575) 935-4358
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NM
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85331783
—
NM
01
—
NM00TB90
BLUE CROSS/BLUE SHIELD
NM
Enumeration date
11/06/2006
Last updated
10/06/2010
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