Healthcare Provider Details

I. General information

NPI: 1265814388
Provider Name (Legal Business Name): EMILY WILLIAMS MERTEN PT, DPT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMILY ELIZABETH WILLIAMS

II. Dates (important events)

Enumeration Date: 06/25/2015
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 THOMAS JOHNSON DR
FREDERICK MD
21702
US

IV. Provider business mailing address

350 NEW FIDELITY CT
GARNER NC
27529-2665
US

V. Phone/Fax

Practice location:
  • Phone: 301-620-7478
  • Fax:
Mailing address:
  • Phone: 919-258-2714
  • Fax: 410-648-4878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRT005245
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number25576
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: