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General NPI Number Information
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NPI Number | 1629886916
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Entity Type | Individual
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Provider Name | MARSHALL EDWARDS
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Gender | Male
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 404 W BROADWELL ST APT 1
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City | ALBION
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State | MI
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Zip | 49224-1079
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Country | US
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Telephone | 269-437-6755
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Fax |
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Provider Business Mailing Address
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Address Line | 307 N SUPERIOR ST
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City | ALBION
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State | MI
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Zip | 49224-1789
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Country | US
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Telephone | 517-657-9133
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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