Provider Demographics
NPI:1437995743
Name:GERANEN, EMILY ELISE (DPT)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:ELISE
Last Name:GERANEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:1233 N NORTHWOOD CENTER CT STE 101
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-6190
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1233 N NORTHWOOD CENTER CT STE 101
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-6190
Practice Address - Country:US
Practice Address - Phone:208-215-2450
Practice Address - Fax:208-773-1473
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ID75717372251S0007X, 2251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic