Individual
JENNIFER A EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5819 BALSAM DR, HUDSONVILLE, MI 49426-1104
(616) 209-5435
Mailing address
4761 LAKE MICHIGAN DR NW STE A, GRAND RAPIDS, MI 49534-6300
(616) 608-9978
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501004400
LICENSE
MI
Enumeration date
09/23/2019
Last updated
09/23/2019
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