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General NPI Number Information
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NPI Number | 1285249672
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Entity Type | Individual
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Provider Name | EMMA NICOLE SHIRLEY PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/11/2020
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Last Update Date | 09/11/2020
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Provider Practice Location Address
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Address Line | 7965 HERITAGE VILLAGE PLZ
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City | GAINESVILLE
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State | VA
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Zip | 20155-3077
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Country | US
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Telephone | 571-486-1899
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Fax |
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Provider Business Mailing Address
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Address Line | 251 ELLISVIEW DR
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City | CARY
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State | NC
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Zip | 27519-6999
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Country | US
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Telephone | 919-208-9852
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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