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Individual

BRENT ANDREW EDWARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
560 SW MCFARLANE AVE FL 32025, LAKE CITY, FL 32025-5614
(386) 758-4777
Mailing address
6542 SW OLD WIRE RD, FORT WHITE, FL 32038-4089
(352) 231-5377

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
30593
FL

Other

Enumeration date
08/09/2021
Last updated
08/09/2021
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