Provider Demographics
NPI:1487308813
Name:SKILLMAN, EMILY SARA (DPT)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:SARA
Last Name:SKILLMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1176 WARFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6005
Mailing Address - Country:US
Mailing Address - Phone:931-552-7455
Mailing Address - Fax:
Practice Address - Street 1:1176 WARFIELD BLVD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6005
Practice Address - Country:US
Practice Address - Phone:931-552-7455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-04
Last Update Date:2024-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0017928225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist