Provider Demographics
NPI:1952827214
Name:KRAFT, EMILY (DPT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:KRAFT
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:LOUISE
Other - Last Name:RAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:290 MERCHANTS SQ STE C
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-0930
Mailing Address - Country:US
Mailing Address - Phone:678-401-2303
Mailing Address - Fax:678-401-2440
Practice Address - Street 1:1915 N 34TH ST
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-5575
Practice Address - Country:US
Practice Address - Phone:877-407-3422
Practice Address - Fax:877-407-4329
Is Sole Proprietor?:No
Enumeration Date:2017-08-18
Last Update Date:2025-04-07
Deactivation Date:2020-10-05
Deactivation Code:
Reactivation Date:2025-02-20
Provider Licenses
StateLicense IDTaxonomies
GAPT013125225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist