Provider Demographics
NPI:1023667979
Name:WERNECKE, EMILY (DPT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WERNECKE
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 1:172 COSTELLO DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-4306
Mailing Address - Country:US
Mailing Address - Phone:540-665-4444
Mailing Address - Fax:540-665-4473
Practice Address - Street 1:230 COSTELLO DR STE 1
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-4686
Practice Address - Country:US
Practice Address - Phone:540-665-4444
Practice Address - Fax:540-665-4473
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305213128225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2305213128OtherVIRGINIA DEPARTMENT OF HEALTH PROFESSIONALS