Provider Demographics
NPI:1639954126
Name:MILNE, EMILEE BLOSSER (PT, DPT)
Entity Type:Individual
Prefix:
First Name:EMILEE
Middle Name:BLOSSER
Last Name:MILNE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:EMILEE
Other - Middle Name:ANNE
Other - Last Name:BLOSSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:401 DAYBREAK DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-5405
Mailing Address - Country:US
Mailing Address - Phone:540-578-4202
Mailing Address - Fax:
Practice Address - Street 1:401 DAYBREAK DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-5405
Practice Address - Country:US
Practice Address - Phone:540-578-4202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14270225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist