Provider Demographics
NPI:1275363590
Name:CLARK, EMILY DILLON (DPT)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:DILLON
Last Name:CLARK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4304 CHESTNUT ST APT 103B
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2964
Mailing Address - Country:US
Mailing Address - Phone:978-732-8276
Mailing Address - Fax:
Practice Address - Street 1:901 E 8TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1354
Practice Address - Country:US
Practice Address - Phone:484-842-4460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist