| Doctor Name: | MR. CHARLES ASHLEY EIDSON |
| NPI Number: | 1528196706 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, MS |
| License Number: | 1322 |
| Business Practice Address: | Pecos Schools Hwy 63 Pecos, NM - 875520368 |
| Business Phone Number: | 5057574644 |
| Business Fax Number: | 5057573049 |
| Mailing Address: | Po Box 368, PECOS |
| State: | NM |
| Postal Code: | 875520368 |
| Phone Number: | 5057574644 |
| Fax Number: | 5057573049 |
| NPI Enumeration Date: | 03/01/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 1322 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |