Individual
URSULA JACINTA EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT, CNMT
Contact information
Practice address
500 LANIER AVE W STE 411, FAYETTEVILLE, GA 30214-7638
(404) 765-0798
Mailing address
500 LANIER AVE W STE 411, FAYETTEVILLE, GA 30214-7638
(404) 765-0798
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MT003516
—
Other
Enumeration date
09/25/2019
Last updated
09/25/2019
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