Provider Demographics
NPI:1851443097
Name:WHITING, EMILY MARIE (MS, ATC)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:MARIE
Last Name:WHITING
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 S WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1447
Mailing Address - Country:US
Mailing Address - Phone:605-521-9544
Mailing Address - Fax:
Practice Address - Street 1:AUGUSTANA COLLEGE ATHLETIC TRAINING
Practice Address - Street 2:2501 S. GRANGE AVE.
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57197-0002
Practice Address - Country:US
Practice Address - Phone:605-274-5543
Practice Address - Fax:605-274-5298
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD02122255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer