Provider Demographics
NPI:1578751863
Name:RUDY, EMILY MICHELE (DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MICHELE
Last Name:RUDY
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 1:438 PELLIS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7900
Mailing Address - Country:US
Mailing Address - Phone:724-850-7587
Mailing Address - Fax:724-850-8329
Practice Address - Street 1:135 E MARKET ST
Practice Address - Street 2:SUITE 107
Practice Address - City:BLAIRSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15717-1369
Practice Address - Country:US
Practice Address - Phone:724-459-7222
Practice Address - Fax:724-459-4933
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018749225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1992214OtherBLUE SHIELD