Basic Information
| Provider Information | |||||||||
| NPI: | 1750622262 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GIBSON | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | GROSCHAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2328 WEST JOPPA ROAD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | LUTHERVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21093 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109388660 | ||||||||
| FaxNumber: | 4109388664 | ||||||||
| Practice Location | |||||||||
| Address1: | 2328 WEST JOPPA ROAD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | LUTHERVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21093 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109388660 | ||||||||
| FaxNumber: | 4109388664 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2013 | ||||||||
| LastUpdateDate: | 08/23/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 9661 | CT | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 2556 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.