Basic Information
| Provider Information | |||||||||
| NPI: | 1265063275 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLEMING | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | DODD | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DODD | ||||||||
| OtherFirstName: | EMILY | ||||||||
| OtherMiddleName: | JOSSELIN | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 60 SHUFORD RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287227406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8288940277 | ||||||||
| FaxNumber: | 8288940278 | ||||||||
| Practice Location | |||||||||
| Address1: | 465 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | SPINDALE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281601235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282870999 | ||||||||
| FaxNumber: | 8282870880 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2020 | ||||||||
| LastUpdateDate: | 01/29/2020 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 01/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | P17325 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.