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General NPI Number Information
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NPI Number | 1093234593
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Entity Type | Organization
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Legal Business Name | EDWARDS CHIROPRACTIC PC
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Dates
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Enumeration Date | 09/15/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 300 S 11TH ST
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City | SAN JOSE
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State | CA
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Zip | 95112-2217
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Country | US
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Telephone | 408-600-1188
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Fax | 408-280-7844
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Provider Business Mailing Address
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Address Line | 300 S 11TH ST
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City | SAN JOSE
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State | CA
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Zip | 95112-2217
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Country | US
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Telephone | 408-600-1188
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Fax | 408-280-7844
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEANA M EDWARDS
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Credential | DC
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Telephone | 408-600-1188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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