Individual
RAVEN SIMONE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3451 GOODMAN RD E STE 108, SOUTHAVEN, MS 38672
(662) 890-6953
(662) 890-6954
Mailing address
800 CRESCENT CENTRE DR STE 600, FRANKLIN, TN 37067-7286
(615) 373-1350
(615) 221-9054
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6541
MS
Other
Enumeration date
06/25/2018
Last updated
08/08/2018
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