Provider Demographics
NPI:1649852963
Name:ATTARD, EMILY (LMT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ATTARD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12277 ROCK DUCK AVE
Mailing Address - Street 2:
Mailing Address - City:WEEKI WACHEE
Mailing Address - State:FL
Mailing Address - Zip Code:34614-1900
Mailing Address - Country:US
Mailing Address - Phone:352-501-1578
Mailing Address - Fax:
Practice Address - Street 1:12277 ROCK DUCK AVE
Practice Address - Street 2:
Practice Address - City:WEEKI WACHEE
Practice Address - State:FL
Practice Address - Zip Code:34614-1900
Practice Address - Country:US
Practice Address - Phone:352-501-1578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA96965225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist