Provider Demographics
NPI:1144714239
Name:JURSCHAK, EMILY E (DPT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:E
Last Name:JURSCHAK
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 1:1005 N GLEBE RD STE 410
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-5931
Mailing Address - Country:US
Mailing Address - Phone:571-414-6930
Mailing Address - Fax:571-414-6941
Practice Address - Street 1:1005 N GLEBE RD STE 410
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-5931
Practice Address - Country:US
Practice Address - Phone:571-414-6930
Practice Address - Fax:571-414-6941
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-21
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
VA2305214011225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist