Provider Demographics
NPI:1891002390
Name:EMERSON, CHARLOTTE A (CPTA)
Entity Type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:A
Last Name:EMERSON
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:OSBORNE
Mailing Address - State:KS
Mailing Address - Zip Code:67473-1802
Mailing Address - Country:US
Mailing Address - Phone:785-945-4007
Mailing Address - Fax:785-346-2222
Practice Address - Street 1:811 N 1ST ST
Practice Address - Street 2:
Practice Address - City:OSBORNE
Practice Address - State:KS
Practice Address - Zip Code:67473-1512
Practice Address - Country:US
Practice Address - Phone:785-346-2114
Practice Address - Fax:785-346-2222
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00405225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant