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1184375016
LARRY WAYNE EDWARDS
BENTON HARBOR, MI
NPI
1184375016
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
324500000X Substance Abuse Rehabilitation Facility
Enumeration Date
2022-01-12
Last Update Date
2022-01-12
Business Address
Mr. LARRY WAYNE EDWARDS BS
1022 E MAIN ST
BENTON HARBOR, MI 49022-3036
Phone number: 269-926-0015
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Mailing Address
Mr. LARRY WAYNE EDWARDS BS
1022 E MAIN ST
BENTON HARBOR, MI 49022-3036
Phone number: 269-926-0015
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