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General NPI Number Information
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NPI Number | 1750226692
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Entity Type | Individual
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Provider Name | DYLAN EDWARDS
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Gender | Female
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 287 RIVERS STREET
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City | BOONE
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State | NC
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Zip | 28608-2009
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Country | US
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Telephone | 423-664-7715
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Fax |
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Provider Business Mailing Address
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Address Line | 138 GOOSES WAY
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City | LAKE LURE
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State | NC
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Zip | 28746-8833
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Country | US
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Telephone | 423-664-7715
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | NC
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