Doctor Name: | GREGORY EDWARDS |
NPI Number: | 1073907093 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT, DPT |
License Number: | 40QA01580400 |
Business Practice Address: | 24 S South Carolina Ave Atlantic City, NJ - 084017241 |
Business Phone Number: | 6093448484 |
Business Fax Number: | |
Mailing Address: | Po Box 1014, CLARK |
State: | NJ |
Postal Code: | 070661014 |
Phone Number: | 7328559751 |
Fax Number: | 7328559755 |
NPI Enumeration Date: | 03/27/2015 |
NPI Last Update Date: | 04/01/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 40QA01580400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
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 |