Individual
MR. CHAD O EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, RD
Contact information
Practice address
975 S FAIRMONT AVE, LODI, CA 95240-5118
(209) 339-7137
Mailing address
975 S FAIRMONT AVE, LODI, CA 95240-5118
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
910324
—
Other
Enumeration date
03/04/2010
Last updated
03/04/2010
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