Individual
MR. EDWIN BANADOS ANDRADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
2129 RIVERSIDE DR, STE B, MACON, GA 31204-6900
(478) 741-9672
(478) 741-9674
Mailing address
2129 RIVERSIDE DR, STE B, MACON, GA 31204-6900
(478) 741-9672
(478) 741-9674
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4246
GA
Other
Enumeration date
08/12/2007
Last updated
10/15/2007
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