MEDICARE: MRS. EMILY LOUISE STRICKLAND P.A.-C.

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	363A00000X	Physician Assistant	1381	TN
2	363A00000X	Physician Assistant	01374	WV

General Provider Information

NPI Number	:	1871670794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMILY LOUISE STRICKLAND P.A.-C.

Provider Business Mailing Address
First Line	:	380 LOWELL DR
Second Line	:
City	:	ELKVIEW
State	:	WV
Zip	:	25071-7672
Country	:	US
Telephone Number	:	304-344-1885
Fax Number	:

Provider Business Practice Location Address
First Line	:	1418 MACCORKLE AVE SW
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25303-1342
Country	:	US
Telephone Number	:	304-348-1066
Fax Number	:

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	05/24/2013

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