Provider Demographics
NPI:1720670862
Name:EDWARDS AND ASSOCIATES PHYSICAL THERAPY
Entity type:Organization
Organization Name:EDWARDS AND ASSOCIATES PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:910-251-8607
Mailing Address - Street 1:159 CROSSOVER RD
Mailing Address - Street 2:
Mailing Address - City:BEULAVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28518-8801
Mailing Address - Country:US
Mailing Address - Phone:910-298-6455
Mailing Address - Fax:910-298-6405
Practice Address - Street 1:159 CROSSOVER RD
Practice Address - Street 2:
Practice Address - City:BEULAVILLE
Practice Address - State:NC
Practice Address - Zip Code:28518-8801
Practice Address - Country:US
Practice Address - Phone:910-298-6455
Practice Address - Fax:910-298-6405
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAROLINA REHABILITATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-10
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty