Healthcare Provider Details

I. General information

NPI: 1124364773
Provider Name (Legal Business Name): EMILY MICHALSKY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2012
Last Update Date: 12/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2990 LEGACY DR
FRISCO TX
75034-6066
US

IV. Provider business mailing address

2990 LEGACY DR
FRISCO TX
75034-6066
US

V. Phone/Fax

Practice location:
  • Phone: 469-888-5172
  • Fax: 469-888-5175
Mailing address:
  • Phone: 469-888-5172
  • Fax: 469-888-5175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number3112788
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: