Provider Demographics
NPI:1700077633
Name:BROGNA, EMELIA PARKER (DPT)
Entity type:Individual
Prefix:DR
First Name:EMELIA
Middle Name:PARKER
Last Name:BROGNA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:EMELIA
Other - Middle Name:MCKENDREE
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:32 ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-5748
Mailing Address - Country:US
Mailing Address - Phone:603-457-3044
Mailing Address - Fax:
Practice Address - Street 1:426 INDUSTRIAL AVE
Practice Address - Street 2:SUITE 190
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-4448
Practice Address - Country:US
Practice Address - Phone:806-860-4360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist