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1750893889
KENT EDWARDS
BENTON, IL
NPI
1750893889
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209016765)
Enumeration Date
2017-10-30
Last Update Date
2017-10-30
Business Address
KENT EDWARDS FNP-C
11488 SUGAR CREEK RD
BENTON, IL 62812-4315
Phone number: 618-927-1610
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Mailing Address
KENT EDWARDS FNP-C
11488 SUGAR CREEK RD
BENTON, IL 62812-4315
Phone number: 618-927-1610
Copy
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