Provider Demographics
NPI:1275867814
Name:GREELER, EMMA JO (LMT)
Entity Type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:JO
Last Name:GREELER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:EMMA
Other - Middle Name:JO
Other - Last Name:SAVAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:919 N 21ST ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-2919
Mailing Address - Country:US
Mailing Address - Phone:740-366-6601
Mailing Address - Fax:740-366-6286
Practice Address - Street 1:919 N 21ST ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-2919
Practice Address - Country:US
Practice Address - Phone:740-366-6601
Practice Address - Fax:740-366-6286
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH15922225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist