Provider Demographics
NPI:1134609761
Name:MAYMON, EMILY LYNN (PT, DPT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:LYNN
Last Name:MAYMON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:LYNN
Other - Last Name:SCHLUETER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:135 ALLEN AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIANA
Mailing Address - State:OH
Mailing Address - Zip Code:44408-1212
Mailing Address - Country:US
Mailing Address - Phone:330-502-9177
Mailing Address - Fax:
Practice Address - Street 1:1801 PHOENIX PL
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-4658
Practice Address - Country:US
Practice Address - Phone:330-502-9177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2022-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12036225100000X
OHPT016956225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist