Basic Information
| Provider Information | |||||||||
| NPI: | 1811423080 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EDWARDS | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | RYAN | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3155 NORTH OSTEOPATHY | ||||||||
| Address2: | |||||||||
| City: | KIRKSVILLE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 63501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6607852304 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1888 W 800 N | ||||||||
| Address2: | |||||||||
| City: | PLEASANT GROVE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840624097 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8016107321 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2017 | ||||||||
| LastUpdateDate: | 08/28/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 204D00000X | UT101823 | UT | Y | Allopathic & Osteopathic Physicians | Neuromusculoskeletal Medicine & OMM |
No ID Information.