Provider Demographics
NPI:1114303682
Name:SALYER, EMMA
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:SALYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 SHAMROCK DR
Mailing Address - Street 2:STE 100-102
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-7325
Mailing Address - Country:US
Mailing Address - Phone:812-479-7337
Mailing Address - Fax:
Practice Address - Street 1:4900 SHAMROCK DR
Practice Address - Street 2:STE 100-102
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-7325
Practice Address - Country:US
Practice Address - Phone:812-479-7337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05011823A2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics