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General NPI Number Information
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NPI Number | 1467450536
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Entity Type | Organization
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Legal Business Name | EDMONDSON PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 12/07/2009
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Provider Practice Location Address
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Address Line | 423 WALNUT ST
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-3129
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Country | US
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Telephone | 330-386-5093
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Fax | 330-386-0571
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Provider Business Mailing Address
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Address Line | 423 WALNUT ST
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-3129
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Country | US
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Telephone | 330-386-5093
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Fax | 330-386-0571
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | LYNN E EDMONDSON
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Credential | LPT
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Telephone | 330-386-5093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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