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General NPI Number Information
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NPI Number | 1578793162
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Entity Type | Organization
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Legal Business Name | EDWARDS THERAPY SERVICES
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Dates
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Enumeration Date | 07/17/2009
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Last Update Date | 07/17/2009
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Provider Practice Location Address
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Address Line | 167 LOCUST AVE
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City | SPRUCE PINE
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State | NC
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Zip | 28777
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Country | US
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Telephone | 828-329-6010
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Fax | 828-765-9655
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Provider Business Mailing Address
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Address Line | PO BOX 953
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City | SPRUCE PINE
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State | NC
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Zip | 28777
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Country | US
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Telephone | 828-329-6010
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Fax | 828-765-9655
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Authorized Official
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Title or Position | OWNER
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Name | MS. BO EDWARDS
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Credential | MS/CCC-SLP
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Telephone | 828-329-6010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 7879
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License Number State | NC
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