Organization
EDMONDSON PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN E EDMONDSON LPT (OWNER PRESIDENT)
(330) 386-5093
Entity
Organization
Contact information
Practice address
423 WALNUT ST, EAST LIVERPOOL, OH 43920-3129
(330) 386-5093
(330) 386-0571
Mailing address
423 WALNUT ST, EAST LIVERPOOL, OH 43920-3129
(330) 386-5093
(330) 386-0571
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000132452
ATHEM BC/BS PROVDER #
OH
05
—
0921220
—
OH
01
—
197528
HIGHMARK BCBS PROV NUMBER
PA
01
—
204068
UPMC PROVIDER
PA
01
—
551723127001
MEDICAL MUTUAL OHIO
OH
01
—
A131408
REHABILICARE
OH
Enumeration date
07/12/2005
Last updated
12/07/2009
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