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General NPI Number Information
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NPI Number | 1578113197
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Entity Type | Individual
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Provider Name | ASHLEY EMERY PT
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Gender | Female
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Dates
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Enumeration Date | 09/16/2019
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Last Update Date | 09/16/2019
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Provider Practice Location Address
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Address Line | 8911 N PORT WASHINGTON RD
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City | BAYSIDE
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State | WI
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Zip | 53217-1634
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Country | US
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Telephone | 414-351-5794
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Fax | 414-351-2770
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Provider Business Mailing Address
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Address Line | 1523 13TH AVE
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City | GRAFTON
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State | WI
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Zip | 53024-1941
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Country | US
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Telephone |
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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 | 14839-24
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License Number State | WI
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