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General NPI Number Information
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NPI Number | 1376091215
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Entity Type | Individual
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Provider Name | JEFFREY LYNN EDWARDS JR. PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 09/20/2016
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Last Update Date | 11/03/2022
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Provider Practice Location Address
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Address Line | 1015 JEFFERSONVILLE COMMONS DR
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-8395
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Country | US
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Telephone | 812-984-3020
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Fax | 812-590-8183
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Provider Business Mailing Address
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Address Line | PO BOX 5629
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City | EVANSVILLE
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State | IN
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Zip | 47716-5629
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Country | US
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Telephone | 502-882-9379
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Fax | 502-805-0526
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT0000010836
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05014851A
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License Number State | IN
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