Provider Demographics
NPI:1346058997
Name:AVERITT, EMILY SARAH (PT, DPT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:SARAH
Last Name:AVERITT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 WOODS EDGE LN
Mailing Address - Street 2:
Mailing Address - City:AUBURNTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37016-6075
Mailing Address - Country:US
Mailing Address - Phone:626-222-8350
Mailing Address - Fax:
Practice Address - Street 1:1116 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-2310
Practice Address - Country:US
Practice Address - Phone:931-684-0027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16095225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist