Individual
MELVIN EDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1705 KINSALE CT, HENRICO, VA 23228-2233
(804) 687-7917
Mailing address
13801 WAR ADMIRAL DR, MIDLOTHIAN, VA 23112-6406
(804) 687-7917
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
08/06/2015
Last updated
08/06/2015
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