Provider Demographics
NPI:1912563552
Name:EDWARDS, KARLIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KARLIE
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 UNIVERSITY PLACE BLVD APT 403
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-3193
Mailing Address - Country:US
Mailing Address - Phone:518-774-2122
Mailing Address - Fax:
Practice Address - Street 1:23 UNIVERSITY PLACE BLVD APT 403
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-3193
Practice Address - Country:US
Practice Address - Phone:518-774-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist