Provider Demographics
NPI:1740928118
Name:DEWEY, ELAINE (DPT)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:DEWEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:
Other - Last Name:KEARNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 632673
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-2673
Mailing Address - Country:US
Mailing Address - Phone:850-897-7772
Mailing Address - Fax:888-308-1539
Practice Address - Street 1:4554 E HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-9755
Practice Address - Country:US
Practice Address - Phone:850-897-7772
Practice Address - Fax:888-308-1539
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT42563225100000X
225100000X
ALPTH11384225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist