Provider Demographics
NPI:1003122268
Name:EDWARDS, LINDSAY SIMMONS (DPT)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:SIMMONS
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:C
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:105 PHYSICIANS PARK DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:SC
Mailing Address - Zip Code:29325-7551
Mailing Address - Country:US
Mailing Address - Phone:864-938-0111
Mailing Address - Fax:864-938-0811
Practice Address - Street 1:105 PHYSICIANS PARK DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325-7551
Practice Address - Country:US
Practice Address - Phone:864-938-0111
Practice Address - Fax:864-938-0811
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5989225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist