Individual
MS. DEIDRA MARIE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
7075 PULASKI AVE, FORT LEONARD WOOD, MO 65473-1041
(573) 842-2650
Mailing address
7075 PULASKI AVE, FORT LEONARD WOOD, MO 65473-1041
(573) 842-2650
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2005020197
MO
282NR1301X
Rural Acute Care Hospital
2005020197
MO
Other
Enumeration date
06/05/2007
Last updated
05/26/2016
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