Individual
MR. CHASE ROSS EDMONDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APC
Contact information
Practice address
523 DIXIE ST, CARROLLTON, GA 30117-3870
(770) 812-8349
Mailing address
523 DIXIE ST, CARROLLTON, GA 30117-3870
(770) 812-8349
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
APC006553
IL
Other
Enumeration date
02/04/2021
Last updated
02/04/2021
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