Provider Demographics
NPI:1760671135
Name:ROBERTS, EMILY A (PT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:A
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232A BOONE HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4926
Mailing Address - Country:US
Mailing Address - Phone:828-268-9043
Mailing Address - Fax:828-268-9045
Practice Address - Street 1:232A BOONE HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4926
Practice Address - Country:US
Practice Address - Phone:828-268-9043
Practice Address - Fax:828-268-9045
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2015-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2296225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist