Healthcare Provider Details
I. General information
NPI: 1285869461
Provider Name (Legal Business Name): TRACEY A EMREY, MSPT DBA FUSION PILATES STUDIO & PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2009
Last Update Date: 05/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
304 NATIONAL RD SUITE 300
EXTON PA
19341-2646
US
IV. Provider business mailing address
304 NATIONAL RD SUITE 300
EXTON PA
19341-2646
US
V. Phone/Fax
- Phone: 610-363-8180
- Fax: 610-363-8190
- Phone: 610-363-8180
- Fax: 610-363-8190
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | PT007916L |
| License Number State | PA |
VIII. Authorized Official
Name: MS.
TRACEY
A
EMREY
Title or Position: SOLE PROPIETOR
Credential: MS PT
Phone: 610-363-8180