MEDICARE: JEFFREY EDWARDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT1437	DC

General Provider Information

NPI Number	:	1699214221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY EDWARDS

Provider Business Mailing Address
First Line	:	908 NEW HAMPSHIRE AVE NW STE 200
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20037-2334
Country	:	US
Telephone Number	:	202-833-5055
Fax Number	:

Provider Business Practice Location Address
First Line	:	908 NEW HAMPSHIRE AVE NW STE 200
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20037-2334
Country	:	US
Telephone Number	:	202-833-5055
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2017
Last Update Date	:	02/15/2017

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Directions to “ JEFFREY EDWARDS ” Practice Location

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