Provider Demographics
NPI:1750622262
Name:GIBSON, EMILY GROSCHAN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:GROSCHAN
Last Name:GIBSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2328 WEST JOPPA ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093
Mailing Address - Country:US
Mailing Address - Phone:410-938-8660
Mailing Address - Fax:410-938-8664
Practice Address - Street 1:2328 WEST JOPPA ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093
Practice Address - Country:US
Practice Address - Phone:410-938-8660
Practice Address - Fax:410-938-8664
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9661225100000X
MD2556225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist