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Individual

BENJAMIN CLAYTON EDWARDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
1322C SUNSET DR, GRENADA, MS 38901-4000
(662) 294-1007
(662) 294-1079
Mailing address
PO BOX 8419, BILOXI, MS 39535-8087
(662) 294-1007
(662) 294-1079

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4886
MS

Other

Enumeration date
11/14/2011
Last updated
06/12/2014
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