Individual
PAUL NELSON EDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
25410 E STATE ROUTE EE, HARRISONVILLE, MO 64701-4403
(816) 260-2924
(816) 884-4703
Mailing address
25410 E STATE ROUTE EE, HARRISONVILLE, MO 64701-4403
(816) 260-2924
(816) 884-4703
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
LC1066421
MO
Other
Enumeration date
03/11/2013
Last updated
03/11/2013
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