Individual
PHILIP L EDGEMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
520 OLD HIGHWAY 68, SWEETWATER, TN 37874-6258
(423) 351-1050
Mailing address
520 OLD HIGHWAY 68, SWEETWATER, TN 37874-6258
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2873
TN
Other
Enumeration date
01/03/2019
Last updated
01/03/2019
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