Provider Demographics
NPI:1043565138
Name:DUMONT, EMILY JEAN (DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JEAN
Last Name:DUMONT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:JEAN
Other - Last Name:TIERNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33B PENN PLZ
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3619
Mailing Address - Country:US
Mailing Address - Phone:207-990-2050
Mailing Address - Fax:207-990-2051
Practice Address - Street 1:132 NEWPORT TOWNE CTR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-7360
Practice Address - Country:US
Practice Address - Phone:423-623-2890
Practice Address - Fax:423-623-2924
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT9422225100000X
MEPT4976225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist