Doctor Name: | JOHN D EDWARDS |
NPI Number: | 1235219015 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 05003445A |
Business Practice Address: | 1411 S Creasy Ln Suite 100 Lafayette, IN - 479057438 |
Business Phone Number: | 7654475552 |
Business Fax Number: | 7654491054 |
Mailing Address: | Po Box 4699, LAFAYETTE |
State: | IN |
Postal Code: | 479034699 |
Phone Number: | 7654492732 |
Fax Number: | 7654491196 |
NPI Enumeration Date: | 10/16/2006 |
NPI Last Update Date: | 03/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 05003445A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
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 |