Healthcare Provider Details

I. General information

NPI: 1689924938
Provider Name (Legal Business Name): EMILY ANNA PARKER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 09/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2680 S MEBANE ST
BURLINGTON NC
27215-5695
US

IV. Provider business mailing address

733 WILLIAMSDALE RD
GRAHAM NC
27253-4382
US

V. Phone/Fax

Practice location:
  • Phone: 336-227-0590
  • Fax:
Mailing address:
  • Phone: 315-212-2959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12016
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: