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NPI Code Detail

MEDICARE: MRS. EMILY GILCHRIST PTA

MEDICARE: MRS. EMILY GILCHRIST PTA
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
1225200000XPhysical Therapy AssistantPTA20827FL

General Provider Information

NPI Number : 1700023413
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EMILY GILCHRIST PTA
Provider Business Mailing Address
First Line : PO BOX 949
Second Line :
City : ROME
State : GA
Zip : 30162-0949
Country : US
Telephone Number : 706-802-1991
Fax Number : 706-802-1408
Provider Business Practice Location Address
First Line : 1897 ISLAND WALK WAY STE 6
Second Line :
City : FERNANDINA BEACH
State : FL
Zip : 32034-1949
Country : US
Telephone Number : 904-261-4664
Fax Number : 904-261-5852
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2009
Last Update Date : 01/16/2009

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