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General NPI Number Information
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NPI Number | 1558103853
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Entity Type | Organization
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Legal Business Name | EMG LAB PLLC
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Dates
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Enumeration Date | 06/10/2024
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 2137 VOLUNTEER PKWY STE 5
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City | BRISTOL
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State | TN
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Zip | 37620-6717
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Country | US
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Telephone | 423-405-0153
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Fax | 949-703-7615
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Provider Business Mailing Address
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Address Line | 2137 VOLUNTEER PKWY STE 5
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City | BRISTOL
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State | TN
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Zip | 37620-6717
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Country | US
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Telephone | 423-405-0153
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Fax | 949-703-7615
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | BRANDON DAVID CLAY SEXTON
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Credential |
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Telephone | 423-405-0153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251E1300X
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Taxonomy Name | Clinical Electrophysiology Physical Therapist
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License Number |
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License Number State |
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