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Individual

BLAKE EDWARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
3801 SELSA RD STE 7, INDEPENDENCE, MO 64057-1712
(816) 795-0434
(816) 795-0482
Mailing address
3801 SELSA RD STE 7, INDEPENDENCE, MO 64057-1712

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2021031365
MO

Other

Enumeration date
08/10/2021
Last updated
08/10/2021
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