Individual
ANN DIANESE LEE EDMONDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
131 16TH ST NW, PULASKI, VA 24301-2433
(540) 392-3774
Mailing address
131 16TH ST NW, PULASKI, VA 24301-2433
(540) 392-3774
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2076700
TX
225200000X
Physical Therapy Assistant
2306602865
VA
Other
Enumeration date
09/21/2010
Last updated
09/21/2010
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