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NPI 1013474147

NPI 1013474147 : EMILY GRAHAM PT, DPT : AUSTIN, TX

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General NPI Number Information
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    NPI Number           |    1013474147
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    Entity Type          |    Individual 
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    Provider Name        |    EMILY GRAHAM PT, DPT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/25/2019
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    Last Update Date     |    02/25/2019
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Provider Practice Location Address
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    Address Line         |    1807 W SLAUGHTER LN STE 475 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78748-6267
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    Country              |    US
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    Telephone            |    512-520-4242
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    13420 LYNDHURST ST APT 101 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78729-1912
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    Country              |    US
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    Telephone            |    325-260-9072
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2251X0800X
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    Taxonomy Name        |    Orthopedic Physical Therapist
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    License Number       |    1313143
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    License Number State |    TX
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