Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 5989 | SC |
NPI | 1003122268 |
---|---|
Provider Name | Mrs. Lindsay Simmons Edwards |
First Address | Clinton, SC 29325-7551 |
Second Address | Clinton, SC 29325-7551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2010 |
Last Update Date | 26/04/2018 |