Doctor Name: | BENJAMIN CLAYTON EDWARDS |
NPI Number: | 1356628622 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | PT4886 |
Business Practice Address: | 1322c Sunset Dr Grenada, MS - 389014000 |
Business Phone Number: | 6622941007 |
Business Fax Number: | 6622941079 |
Mailing Address: | Po Box 8419, BILOXI |
State: | MS |
Postal Code: | 395358087 |
Phone Number: | 6622941007 |
Fax Number: | 6622941079 |
NPI Enumeration Date: | 11/14/2011 |
NPI Last Update Date: | 06/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT4886 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
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 |