Individual
MR. EDWARD H EAVES
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
815 W MARKET ST, GREENSBORO, NC 27401-1823
(336) 272-7102
Mailing address
3351 OLD BARN RD, GREENSBORO, NC 27410-9600
(336) 288-3280
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0764
NC
Other
Enumeration date
02/16/2006
Last updated
07/08/2007
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