Provider Demographics
NPI:1619603438
Name:TUGGLE, EMILY WILLIAMS (PT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:WILLIAMS
Last Name:TUGGLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 S MADISON ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6391
Mailing Address - Country:US
Mailing Address - Phone:662-844-8754
Mailing Address - Fax:662-844-8741
Practice Address - Street 1:1041 S MADISON ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6391
Practice Address - Country:US
Practice Address - Phone:662-844-8754
Practice Address - Fax:662-844-8741
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT7427225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist