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General NPI Number Information
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NPI Number | 1598340267
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Entity Type | Individual
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Provider Name | EMILY MCDANIEL PTA
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Gender | Female
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Dates
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Enumeration Date | 03/15/2021
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 650A HIGHLAND COLONY PKWY
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City | RIDGELAND
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State | MS
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Zip | 39157-8000
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Country | US
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Telephone | 769-666-6047
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Fax |
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Provider Business Mailing Address
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Address Line | 6811 OLD CANTON RD APT 4804
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City | RIDGELAND
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State | MS
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Zip | 39157-1250
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Country | US
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Telephone | 601-421-4565
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA6479
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License Number State | MS
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