Healthcare Provider Details

I. General information

NPI: 1083598346
Provider Name (Legal Business Name): EMMA CELESTE STURTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

467 SHELBY ONTARIO RD
ONTARIO OH
44906-1029
US

IV. Provider business mailing address

4289 ALGIRE RD
LEXINGTON OH
44904-9576
US

V. Phone/Fax

Practice location:
  • Phone: 419-529-3969
  • Fax:
Mailing address:
  • Phone: 567-241-6585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT007367
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: