Provider Demographics
NPI:1114480415
Name:EDWARDS ABSOLUTE KINETICS
Entity Type:Organization
Organization Name:EDWARDS ABSOLUTE KINETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, EDD, OCS, CERT
Authorized Official - Phone:740-839-9240
Mailing Address - Street 1:68582 GRISSOM LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-8778
Mailing Address - Country:US
Mailing Address - Phone:740-839-9240
Mailing Address - Fax:
Practice Address - Street 1:50843 VALLEY PLAZA DR
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-1753
Practice Address - Country:US
Practice Address - Phone:740-839-9240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-12
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty