Provider Demographics
NPI:1679807341
Name:EDWARDS, DAVID JAMES (DPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JAMES
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 1:50843 VALLEY PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-1753
Mailing Address - Country:US
Mailing Address - Phone:740-359-7459
Mailing Address - Fax:740-994-0634
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
Practice Address - Country:US
Practice Address - Phone:740-359-7459
Practice Address - Fax:740-994-0634
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV003540225100000X
OH012633225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist