Provider Demographics
NPI:1285711994
Name:EDLING, JUDITH M (DC)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:M
Last Name:EDLING
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BLUE EARTH
Mailing Address - State:MN
Mailing Address - Zip Code:56013-2010
Mailing Address - Country:US
Mailing Address - Phone:507-526-3434
Mailing Address - Fax:
Practice Address - Street 1:112 E 8TH ST
Practice Address - Street 2:
Practice Address - City:BLUE EARTH
Practice Address - State:MN
Practice Address - Zip Code:56013-2010
Practice Address - Country:US
Practice Address - Phone:507-526-3434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1947111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN366727800Medicaid
MN42161EDOtherBLUE CROSS BLUE SHIELD MN
MN359000355Medicare ID - Type Unspecified
MN366727800Medicaid