Provider Demographics
NPI:1972848356
Name:LOURIE, EMIY M (DPT)
Entity Type:Individual
Prefix:MRS
First Name:EMIY
Middle Name:M
Last Name:LOURIE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 LIVERMORE FALLS RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-6241
Mailing Address - Country:US
Mailing Address - Phone:207-778-6591
Mailing Address - Fax:207-778-0862
Practice Address - Street 1:119 LIVERMORE FALLS RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-6241
Practice Address - Country:US
Practice Address - Phone:207-778-6591
Practice Address - Fax:207-779-0862
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT3424225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist