Provider Demographics
NPI:1457595548
Name:EDWARDS, AMY PRICE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:PRICE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15205 BOWLING GREEN RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:VA
Mailing Address - Zip Code:23487-7329
Mailing Address - Country:US
Mailing Address - Phone:757-356-1760
Mailing Address - Fax:
Practice Address - Street 1:1401 N HIGH ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:VA
Practice Address - Zip Code:23851-1244
Practice Address - Country:US
Practice Address - Phone:757-516-8130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203868225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist