Provider Demographics
NPI:1417599630
Name:LEHECKA, EMILY (PT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:LEHECKA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 HICKORY PARK DR STE 110
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-2629
Mailing Address - Country:US
Mailing Address - Phone:047-568-4958
Mailing Address - Fax:
Practice Address - Street 1:5618H OX RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX STATION
Practice Address - State:VA
Practice Address - Zip Code:22039-1018
Practice Address - Country:US
Practice Address - Phone:703-426-4949
Practice Address - Fax:703-426-4977
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1277801225100000X
VA2305214235225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist