Basic Information
Provider Information
NPI: 1538422969
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAPMAN
FirstName: EMILY
MiddleName: RYAN
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 235 E STATE ST
Address2:  
City: SAINT CROIX FALLS
State: WI
PostalCode: 540244117
CountryCode: US
TelephoneNumber: 7154833261
FaxNumber: 7154830507
Practice Location
Address1: 235 E STATE ST
Address2:  
City: SAINT CROIX FALLS
State: WI
PostalCode: 540244117
CountryCode: US
TelephoneNumber: 7154833261
FaxNumber: 7154830507
Other Information
ProviderEnumerationDate: 06/20/2012
LastUpdateDate: 11/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/03/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X8642MNN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X9090AZN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X16138WIY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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