Provider Demographics
NPI:1396183455
Name:BUSKIRK, EMILY ANN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ANN
Last Name:BUSKIRK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:ANN
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:235 W AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32505-2239
Mailing Address - Country:US
Mailing Address - Phone:850-857-5200
Mailing Address - Fax:
Practice Address - Street 1:235 W AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32505-2239
Practice Address - Country:US
Practice Address - Phone:850-857-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23779225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant