MEDICARE: MRS. TONI O EDWARDS PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT001910	GA

General Provider Information

NPI Number	:	1952620023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TONI O EDWARDS PT

Provider Business Mailing Address
First Line	:	6135 ROOSEVELT HIGHWAY
Second Line	:	ROOSEVELT WARM SPRINGS REHABILITATION CENTER
City	:	WARM SPRINGS
State	:	GA
Zip	:	31830-1000
Country	:	US
Telephone Number	:	706-655-5636
Fax Number	:

Provider Business Practice Location Address
First Line	:	6135 ROOSEVELT HIGHWAY
Second Line	:
City	:	WARM SPRINGS
State	:	GA
Zip	:	31830-1000
Country	:	US
Telephone Number	:	706-655-5636
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2010
Last Update Date	:	05/27/2010

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