Basic Information
Provider Information
NPI: 1003055146
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARRIS
FirstName: EMILY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 883299
Address2:  
City: STEAMBOAT SPRINGS
State: CO
PostalCode: 804883299
CountryCode: US
TelephoneNumber: 9708798026
FaxNumber:  
Practice Location
Address1: 1585 MID-VALLEY DR
Address2: #3 KINETIC ENERGY PHYSICAL THERAPY PC
City: STEAMBOAT SPRINGS
State: CO
PostalCode: 80487
CountryCode: US
TelephoneNumber: 9708798026
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/12/2009
LastUpdateDate: 02/12/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X9170COY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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