Provider Demographics
NPI:1518426600
Name:EDWARDS, JOSH R (DPT)
Entity Type:Individual
Prefix:DR
First Name:JOSH
Middle Name:R
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 NORTH BRIDGE STREET
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621
Mailing Address - Country:US
Mailing Address - Phone:336-970-0324
Mailing Address - Fax:
Practice Address - Street 1:231 MELTON RD
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-9067
Practice Address - Country:US
Practice Address - Phone:336-970-0324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP17742225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist