NPI 1902194434

Sheredrick Anthony Edmundson

Practitioner Contractor Antioch, TN

Practice location

Address: 4233 Shagbark Trl, Antioch, TN 37013-7311
Phone: (615) 578-2541
Fax: (615) 280-1160

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence 00017384 (TN)

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Registry record

NPI: 1902194434
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Jul 2011
Record last updated: 19 Jul 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.