Individual
HEIDI MARIE EDMONDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AT STUDENT
Contact information
Practice address
5110 HYDE RD, CUMMING, GA 30040-4951
(678) 620-5069
Mailing address
5110 HYDE RD, CUMMING, GA 30040-4951
(678) 620-5069
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/17/2023
Last updated
02/17/2023
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