MEDICARE: EMILY STEWART PT, 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	016510	OH

General Provider Information

NPI Number	:	1790224202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY STEWART PT, DPT

Provider Business Mailing Address
First Line	:	850 COLUMBIA RD STE 110
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-7213
Country	:	US
Telephone Number	:	440-250-5767
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 COLUMBIA RD STE 110
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-7213
Country	:	US
Telephone Number	:	440-250-5767
Fax Number	:

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

Provider Enumeration Date	:	02/16/2017
Last Update Date	:	02/16/2017

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