Individual
GAVIN WADE EDMONDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5701 DELHI RD, CINCINNATI, OH 45233-1669
(478) 297-6793
(478) 297-6793
Mailing address
5701 DELHI RD, CINCINNATI, OH 45233-1669
(478) 297-6793
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/14/2017
Last updated
06/14/2017
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