Individual
CHAD STEVEN EDMINSTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, PA-C
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT233
OK
363AM0700X
Medical Physician Assistant
Primary
2464
OK
363AS0400X
Surgical Physician Assistant
2464
OK
Other
Enumeration date
05/29/2007
Last updated
12/22/2014
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