Basic Information
| Provider Information | |||||||||
| NPI: | 1417366196 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | BICKERS | ||||||||
| FirstName: | EMILY | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 22184 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402520184 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5024251716 | ||||||||
| FaxNumber: | 5024252258 | ||||||||
| Practice Location | |||||||||
| Address1: | 4042 DUTCHMANS LN | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402074712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028999363 | ||||||||
| FaxNumber: | 5028999365 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2014 | ||||||||
| LastUpdateDate: | 03/08/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 05011448A | IN | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 007038 | KY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.