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Individual

HOWARD WILLIAM EDMISTON IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, RD, LD

Contact information

Practice address
117 ALAMO DR, RUIDOSO, NM 88345-7253
(910) 476-1822
Mailing address
117 ALAMO DR, RUIDOSO, NM 88345-7253
(910) 476-1822

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-1166
NM

Other

Enumeration date
07/05/2021
Last updated
07/05/2021
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