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Individual

BOBBI S EDSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
108 6TH AVE, KINDER, LA 70648-3187
(337) 738-9494
Mailing address
108 6TH AVE, KINDER, LA 70648-3187
(337) 738-9494

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA200640
LA
363A00000X
Physician Assistant
PA9101513
FL

Other

Enumeration date
03/06/2008
Last updated
07/31/2013
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