Individual
BRIAN H EDMUNDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, NCS
Contact information
Practice address
2004 SANDBRIDGE RD, SUITE 102, VIRGINIA BEACH, VA 23456-4084
(757) 301-6316
(757) 301-6419
Mailing address
771 PILOT HOUSE DR, NEWPORT NEWS, VA 23606-1990
(757) 873-2302
(757) 873-2306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305003982
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114234309
—
VA
01
—
9958609
AETNA
VA
Enumeration date
09/09/2010
Last updated
01/18/2011
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