Provider Demographics
NPI:1689497620
Name:PIER, EMMALYNN I (LMT)
Entity type:Individual
Prefix:
First Name:EMMALYNN
Middle Name:I
Last Name:PIER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 CLYDE MORRIS BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8187
Mailing Address - Country:US
Mailing Address - Phone:386-800-3100
Mailing Address - Fax:
Practice Address - Street 1:305 CLYDE MORRIS BLVD
Practice Address - Street 2:220
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8187
Practice Address - Country:US
Practice Address - Phone:386-800-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6022760111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty