Provider Demographics
NPI:1184178493
Name:EDWARDS, KATHRYN (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:FERRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6041B GARNERS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-1304
Mailing Address - Country:US
Mailing Address - Phone:803-783-0684
Mailing Address - Fax:803-783-1147
Practice Address - Street 1:6041B GARNERS FERRY RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-1304
Practice Address - Country:US
Practice Address - Phone:803-783-0684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCCP037357T225100000X
LA11691R225100000X
GAPT012454225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist