Provider Demographics
NPI:1437229853
Name:EDMONDS, STEVEN D (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:D
Last Name:EDMONDS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-3320
Mailing Address - Country:US
Mailing Address - Phone:781-381-0131
Mailing Address - Fax:
Practice Address - Street 1:8 PARK PLZ
Practice Address - Street 2:CITY PLACE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-3952
Practice Address - Country:US
Practice Address - Phone:617-451-1111
Practice Address - Fax:617-973-9933
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACH1289111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic