Individual
CHRISTOPHER EDMONSOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1950 BLUEWATER BLVD, SUITE 101, NICEVILLE, FL 32578-3887
(850) 897-3334
(850) 897-7855
Mailing address
PO BOX 1772, SUITE 101, CRESTVIEW, FL 32536-7772
(850) 682-7772
(850) 682-1539
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT23309
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
892071100
—
FL
01
—
BQ086Z
MEDICARE PTAN
FL
01
—
Y906W
BCBSFL GRP #
FL
Enumeration date
04/09/2007
Last updated
05/27/2016
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