Provider Demographics
NPI:1295124568
Name:DILLARD, EMILY GRAHAM (PT, DPT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:GRAHAM
Last Name:DILLARD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ANNE
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2564
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:12110 COUNTY LINE RD STE B
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35756-2009
Practice Address - Country:US
Practice Address - Phone:256-232-9001
Practice Address - Fax:256-233-1001
Is Sole Proprietor?:No
Enumeration Date:2015-01-09
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH7936225100000X, 225100000X
MSPT5612225100000X
TN11281225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist