Provider Demographics
NPI:1821564543
Name:EDWARDS, KENYA (DC)
Entity Type:Individual
Prefix:DR
First Name:KENYA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7910 MALL RING RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-2698
Mailing Address - Country:US
Mailing Address - Phone:470-395-3142
Mailing Address - Fax:949-553-3508
Practice Address - Street 1:7910 MALL RING RD STE 300
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-2698
Practice Address - Country:US
Practice Address - Phone:470-395-3142
Practice Address - Fax:949-553-3508
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-20
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010132111NR0400X, 111NR0400X
GACHIRO10132111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation