Provider Demographics
NPI:1891110490
Name:MONROE, EMILY LILLARD (PTA)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:LILLARD
Last Name:MONROE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 BLACKEY BANDY RD
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37022-9193
Mailing Address - Country:US
Mailing Address - Phone:931-349-8045
Mailing Address - Fax:
Practice Address - Street 1:258 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-2961
Practice Address - Country:US
Practice Address - Phone:615-452-9686
Practice Address - Fax:615-452-9652
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5565225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant