Provider Demographics
NPI:1265836795
Name:MEHRER, EMILY N (PT, DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:N
Last Name:MEHRER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:D
Other - Last Name:NARET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:PO BOX 69030
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-9030
Mailing Address - Country:US
Mailing Address - Phone:757-873-2302
Mailing Address - Fax:757-873-2306
Practice Address - Street 1:4831 S LABURNUM AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-2713
Practice Address - Country:US
Practice Address - Phone:800-422-2074
Practice Address - Fax:804-222-0748
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305208741225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1265836795OtherMEDICAID QMB PROVIDER ID
VAC05954OtherMEDICARE GROUP PTAN
VAC05954OtherMEDICARE GROUP PTAN