Provider Demographics
NPI:1699010017
Name:PAYNE, EMILY BETH (DPT)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:BETH
Last Name:PAYNE
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 1:7330 KNOTTSVILLE MOUNT ZION RD
Mailing Address - Street 2:
Mailing Address - City:PHILPOT
Mailing Address - State:KY
Mailing Address - Zip Code:42366-9730
Mailing Address - Country:US
Mailing Address - Phone:270-315-8360
Mailing Address - Fax:
Practice Address - Street 1:7330 KNOTTSVILLE MOUNT ZION RD
Practice Address - Street 2:
Practice Address - City:PHILPOT
Practice Address - State:KY
Practice Address - Zip Code:42366-9730
Practice Address - Country:US
Practice Address - Phone:270-315-8360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006054225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist