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General NPI Number Information
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NPI Number | 1396939039
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Entity Type | Individual
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Provider Name | KEVIN WAYNE EDWARDS PT
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Gender | Male
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Dates
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Enumeration Date | 09/05/2007
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Last Update Date | 09/05/2007
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Provider Practice Location Address
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Address Line | 3950 BRODHEAD RD SUITE 300
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City | MONACA
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State | PA
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Zip | 15061-3030
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Country | US
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Telephone | 724-774-8245
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Fax | 724-774-0168
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Provider Business Mailing Address
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Address Line | 240 PRINCETON DR
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City | ALIQUIPPA
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State | PA
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Zip | 15001-1553
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Country | US
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Telephone | 724-203-0420
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Fax | 724-869-0195
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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 | PT011338L
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License Number State | PA
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