Individual
MR. LARRY WAYNE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
1022 E MAIN ST, BENTON HARBOR, MI 49022-3036
(269) 926-0015
(269) 926-0123
Mailing address
1022 E MAIN ST, BENTON HARBOR, MI 49022-3036
(269) 926-0015
(269) 926-0123
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
01/12/2022
Last updated
01/12/2022
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