Individual
DIANA EDMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3007 HARBOR LN N STE 1200, PLYMOUTH, MN 55447-5103
(612) 445-8314
Mailing address
7925 NOBLE AVE N, BROOKLYN PARK, MN 55443-2410
(847) 946-2946
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
01/25/2021
Last updated
01/25/2021
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