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General NPI Number Information
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NPI Number | 1922289768
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Entity Type | Individual
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Provider Name | MARSHA TRACELYN EDWARDS COLON MSPT
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Gender | Female
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 12/27/2022
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Provider Practice Location Address
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Address Line | 19441 GOLF VISTA PLZ STE 340
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City | LANSDOWNE
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State | VA
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Zip | 20176-8272
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Country | US
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Telephone | 703-723-7726
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Fax |
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Provider Business Mailing Address
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Address Line | 10529 BLAZING STAR LOOP
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City | BRISTOW
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State | VA
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Zip | 20136-2212
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Country | US
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Telephone | 301-452-2168
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305204344
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License Number State | VA
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