Individual
MR. EDWARD JOHN ERVIN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
1001 SAM PERRY BLVD, FREDERICKSBURG, VA 22401-4453
(540) 741-1547
Mailing address
3304 LAKEVIEW PKWY, LOCUST GROVE, VA 22508-5706
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119000210
VA
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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