Provider Demographics
NPI:1225765456
Name:JOSEPHSON, EMILY LUCIA (DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:LUCIA
Last Name:JOSEPHSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 WALNUT ST UNIT 401
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-3157
Mailing Address - Country:US
Mailing Address - Phone:774-320-0590
Mailing Address - Fax:
Practice Address - Street 1:1519 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-4415
Practice Address - Country:US
Practice Address - Phone:781-436-0391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic