Organization
EDENWAY BIRTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHARLOTTE ELIZABETH RUSSELL C.P.M. (CLINICAL DIRECTOR)
(318) 272-8295
Entity
Organization
Contact information
Practice address
404 UNIVERSITY AVE, MARSHALL, TX 75670-5262
(318) 272-8295
Mailing address
404 UNIVERSITY AVE, MARSHALL, TX 75670-5262
(318) 272-8295
Taxonomy
Speciality
Code
Description
License number
State
261QB0400X
Birthing Clinic/Center
Primary
—
—
Other
Enumeration date
05/20/2009
Last updated
05/20/2009
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