Organization
EDISON EVOLUTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN EDDLEMAN (CFO)
(918) 808-1802
Entity
Organization
Contact information
Practice address
100 S RIVERFRONT DR STE 400, JENKS, OK 74037-5660
(918) 808-1802
(918) 528-5910
Mailing address
100 S RIVERFRONT DR STE 400, JENKS, OK 74037-5660
(918) 808-1802
(918) 528-5910
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
02/14/2022
Last updated
02/14/2022
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