Provider Demographics
NPI:1669831905
Name:TUTTLE, EMMA KATHERINE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:KATHERINE
Last Name:TUTTLE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4915
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:2001 N STATE ROUTE 7 STE B
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:MO
Practice Address - Zip Code:64080-8005
Practice Address - Country:US
Practice Address - Phone:816-987-7049
Practice Address - Fax:816-987-2606
Is Sole Proprietor?:No
Enumeration Date:2016-02-15
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-05833225100000X
MO2016003534225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist