Provider Demographics
NPI:1831648211
Name:BATTLE, EDWIN RA'SHAD (LMT)
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:RA'SHAD
Last Name:BATTLE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 ADDISON DR
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040-5644
Mailing Address - Country:US
Mailing Address - Phone:205-915-7893
Mailing Address - Fax:
Practice Address - Street 1:181 W VALLEY AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-3691
Practice Address - Country:US
Practice Address - Phone:205-718-5144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4322225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist