Provider Demographics
NPI:1588601520
Name:EDWARDS, CHARLIE DAVID (PT)
Entity Type:Individual
Prefix:DR
First Name:CHARLIE
Middle Name:DAVID
Last Name:EDWARDS
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Gender:M
Credentials:PT
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Mailing Address - Street 1:1350 E ARLINGTON BLVD
Mailing Address - Street 2:SUITE A KINETIC PHYSICAL THERAPY AND WELLNESS, INC.
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-7850
Mailing Address - Country:US
Mailing Address - Phone:252-364-2806
Mailing Address - Fax:252-364-2863
Practice Address - Street 1:1330 E ARLINGTON BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-7850
Practice Address - Country:US
Practice Address - Phone:252-758-7048
Practice Address - Fax:252-215-5614
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2022-05-26
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Provider Licenses
StateLicense IDTaxonomies
NC2748225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist