Healthcare Provider Details

I. General information

NPI: 1346058997
Provider Name (Legal Business Name): EMILY SARAH AVERITT PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 N MAIN ST
SHELBYVILLE TN
37160-2310
US

IV. Provider business mailing address

162 WOODS EDGE LN
AUBURNTOWN TN
37016-6075
US

V. Phone/Fax

Practice location:
  • Phone: 931-684-0027
  • Fax:
Mailing address:
  • Phone: 626-222-8350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number16095
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: