Individual
MR. EDWIN M VILLAESPN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
409 E 10TH ST STE 305, ANNISTON, AL 36207-4781
(256) 238-0110
(256) 238-5143
Mailing address
1225 RIVER RUN RD W, SOUTHSIDE, AL 35907-6903
(256) 442-2152
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PTH1696
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTH1696
PHYSICAL THERAPIST LICENS
AL
Enumeration date
12/11/2006
Last updated
07/08/2007
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