Provider Demographics
NPI:1003101064
Name:EDWARDS, VERONICA V (PT)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:V
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2825 WINDY HILL RD SE
Mailing Address - Street 2:APT 8301
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-6106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1720 POWERS FERRY RD SE
Practice Address - Street 2:SUITE 100
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-5442
Practice Address - Country:US
Practice Address - Phone:770-955-2225
Practice Address - Fax:770-953-6658
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAPT010545225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist