Provider Demographics
NPI:1598005407
Name:GILMORE, EMILY WILSON (DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:WILSON
Last Name:GILMORE
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 1:1100 BEACON PKWY E
Mailing Address - Street 2:V204
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-1020
Mailing Address - Country:US
Mailing Address - Phone:251-402-4858
Mailing Address - Fax:
Practice Address - Street 1:3800 RIVER RUN DR
Practice Address - Street 2:SUITE 102
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35243-4701
Practice Address - Country:US
Practice Address - Phone:205-970-2350
Practice Address - Fax:205-970-2165
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH6757225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist