Provider Demographics
NPI:1124913348
Name:SEWELL, EMMA (DPT)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:SEWELL
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 1:10024 TALAVERA TRL UNIT A
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72916-4097
Mailing Address - Country:US
Mailing Address - Phone:318-990-0589
Mailing Address - Fax:
Practice Address - Street 1:4900 ROGERS AVE STE 100F
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-2068
Practice Address - Country:US
Practice Address - Phone:479-242-9771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR5635225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist