Provider Demographics
NPI:1750800843
Name:EDGE PHYSICAL MEDICINE INC
Entity type:Organization
Organization Name:EDGE PHYSICAL MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-671-0600
Mailing Address - Street 1:1327 E KEMPER RD STE 3100B
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-3945
Mailing Address - Country:US
Mailing Address - Phone:513-670-0600
Mailing Address - Fax:513-671-0999
Practice Address - Street 1:3090 ANGEL DR
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:OH
Practice Address - Zip Code:45106
Practice Address - Country:US
Practice Address - Phone:513-734-6555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EDGE PHYSICAL MEDICINE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-11
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty