MEDICARE: EMILY SKIPPER DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1245888635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY SKIPPER DPT

Provider Business Mailing Address
First Line	:	12508 JONES MALTSBERGER RD STE 110
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-4215
Country	:	US
Telephone Number	:	210-590-4000
Fax Number	:	210-590-4585

Provider Business Practice Location Address
First Line	:	4300 WESTBANK DR STE 210
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-6624
Country	:	US
Telephone Number	:	512-306-8071
Fax Number	:	512-306-8518

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2019
Last Update Date	:	08/28/2019

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Directions to “ EMILY SKIPPER DPT” Practice Location

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