Provider Demographics
NPI:1700037918
Name:DORMAN, EMILY ANNE (ATC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANNE
Last Name:DORMAN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ANNE
Other - Last Name:MARKIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:235 S 33RD ST
Mailing Address - Street 2:WEIGHTMAN HALL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3807
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:235 S 33RD ST
Practice Address - Street 2:WEIGHTMAN HALL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3807
Practice Address - Country:US
Practice Address - Phone:215-746-1372
Practice Address - Fax:215-573-8646
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARTO0000082255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer