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General NPI Number Information
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NPI Number | 1972721769
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Entity Type | Organization
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Legal Business Name | DONNA M EDWARDS PT OCS
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10429 HICKORY PATH WAY
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City | KNOXVILLE
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State | TN
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Zip | 37922-3296
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Country | US
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Telephone | 865-560-2709
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Fax | 865-560-2710
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Provider Business Mailing Address
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Address Line | 10429 HICKORY PATH WAY
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City | KNOXVILLE
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State | TN
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Zip | 37922-3296
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Country | US
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Telephone | 865-560-2709
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Fax | 865-560-2710
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MS. DONNA MARIE EDWARDS
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Credential | PT OCS
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Telephone | 865-560-2709
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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 | PT0000001656
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License Number State | TN
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