Provider Demographics
NPI:1619621216
Name:KIRKWOOD, EMILY RENEE (DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:RENEE
Last Name:KIRKWOOD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:RENEE
Other - Last Name:FRIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2757 LEECHBURG RD
Mailing Address - Street 2:
Mailing Address - City:LOWER BURRELL
Mailing Address - State:PA
Mailing Address - Zip Code:15068-3138
Mailing Address - Country:US
Mailing Address - Phone:724-337-6522
Mailing Address - Fax:724-337-0630
Practice Address - Street 1:11931 STATE ROUTE 85
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-3741
Practice Address - Country:US
Practice Address - Phone:724-543-1627
Practice Address - Fax:724-545-3415
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT030168225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist