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Individual

SAMUEL EDWARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3890 REDWINE RD SW, ATLANTA, GA 30331-5582
(404) 344-7880
Mailing address
3890 REDWINE RD SW, ATLANTA, GA 30331-5582
(404) 344-7880

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA005048
GA

Other

Enumeration date
09/15/2023
Last updated
09/15/2023
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