Individual
MRS. MELODY ANN EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
25 14TH AVE S, NAMPA, ID 83651-4394
(208) 465-1890
(208) 467-9131
Mailing address
6599 WARREN SPUR RD, MELBA, ID 83641-5227
(208) 409-3565
(208) 467-9131
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-695
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000922000
—
ID
Enumeration date
02/24/2007
Last updated
04/16/2010
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