Organization
EDGE LUXE IMAGE CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANDI RAE BOZEMAN (OWNER)
(937) 241-2972
Entity
Organization
Contact information
Practice address
112 MAGNOLIA ST, BEAVERCREEK, OH 45440-1370
(937) 241-2972
Mailing address
112 MAGNOLIA ST, BEAVERCREEK, OH 45440-1370
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
08/27/2013
Last updated
08/27/2013
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