Provider Demographics
NPI:1679092233
Name:HUTCHISON, EMELY MICHELE (DPT,PT)
Entity Type:Individual
Prefix:
First Name:EMELY
Middle Name:MICHELE
Last Name:HUTCHISON
Suffix:
Gender:F
Credentials:DPT,PT
Other - Prefix:
Other - First Name:EMELY
Other - Middle Name:MICHELE
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT,PT
Mailing Address - Street 1:33900 HARPER AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:586-350-2644
Mailing Address - Fax:
Practice Address - Street 1:856 N SUPERIOR DR
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-8299
Practice Address - Country:US
Practice Address - Phone:219-213-3942
Practice Address - Fax:219-213-3943
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT33478225100000X
IN05012685A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist