MEDICARE: DR. EMILY KATHLEEN DRISCOLL PT

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	2305212168	VA

General Provider Information

NPI Number	:	1437638996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMILY KATHLEEN DRISCOLL PT

Provider Business Mailing Address
First Line	:	9211 FOREST HILL AVE STE 204
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23235-6877
Country	:	US
Telephone Number	:	804-985-1234
Fax Number	:

Provider Business Practice Location Address
First Line	:	9211 FOREST HILL AVE APT 302
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23235-6874
Country	:	US
Telephone Number	:	804-985-1234
Fax Number	:	183-338-9170

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

Provider Enumeration Date	:	08/07/2018
Last Update Date	:	10/20/2020

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