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Individual

MRS. ALYSSA BRYANT EDENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
1120 15TH ST, AUGUSTA, GA 30912-3820
(706) 721-2273
Mailing address
6140 WOODSIDE EXECUTIVE CT, AIKEN, SC 29803-3820
(803) 642-0700
(803) 642-0588

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
8161
SC
225100000X
Physical Therapist
Primary
PT012677
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8161
STATE LICENSE
SC
01
PT012677
STATE LIC
GA
Enumeration date
06/05/2016
Last updated
06/14/2024
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