MEDICARE: RYAN EDWARDS DPT

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	225100000X	Physical Therapist	14283	TN

General Provider Information

NPI Number	:	1912642828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN EDWARDS DPT

Provider Business Mailing Address
First Line	:	4109 MOUNTAIN VIEW AVE STE 100
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37415-2096
Country	:	US
Telephone Number	:	423-842-9322
Fax Number	:	866-591-0619

Provider Business Practice Location Address
First Line	:	115 N MARKET ST
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37405-3904
Country	:	US
Telephone Number	:	423-842-9322
Fax Number	:	866-591-0619

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

Provider Enumeration Date	:	05/04/2022
Last Update Date	:	12/10/2025

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