Individual
MARTHA EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
51 HARRISON AVE, WEST ORANGE, NJ 07052-5922
(973) 634-2008
Mailing address
51 HARRISON AVE, WEST ORANGE, NJ 07052-5922
(973) 634-2008
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00242500
NJ
Other
Enumeration date
03/11/2011
Last updated
03/11/2011
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