Provider Demographics
NPI:1487787685
Name:CURRY, EMMIE BOSTIAN (PT)
Entity type:Individual
Prefix:MS
First Name:EMMIE
Middle Name:BOSTIAN
Last Name:CURRY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:EMMIE
Other - Middle Name:LYNETTE
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:232 HARPER ST
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-3814
Mailing Address - Country:US
Mailing Address - Phone:336-765-7246
Mailing Address - Fax:336-765-7246
Practice Address - Street 1:232 HARPER ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27104-3814
Practice Address - Country:US
Practice Address - Phone:336-765-7246
Practice Address - Fax:336-765-7246
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16642251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211680Medicaid