Provider Demographics
NPI:1013545383
Name:EDWARDS, RODNEY (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 E PONCE DE LEON AVE STE 160
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-3488
Mailing Address - Country:US
Mailing Address - Phone:404-377-9107
Mailing Address - Fax:
Practice Address - Street 1:235 E PONCE DE LEON AVE STE 160
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3488
Practice Address - Country:US
Practice Address - Phone:404-377-9107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT014527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist