Individual
JAMIE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1301 E SUNSHINE ST, SPRINGFIELD, MO 65804
(417) 889-4800
Mailing address
PO BOX 9163, SPRINGFIELD, MO 65801
(417) 889-4800
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2018043371
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018043371
LICENSE #
MO
Enumeration date
10/14/2019
Last updated
10/14/2019
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