| Doctor Name: | EMILY JANE VAN DE WATER |
| NPI Number: | 1265798359 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, DPT |
| License Number: | 1210526 |
| Business Practice Address: | 222 W 39th Ave San Mateo, CA - 944034364 |
| Business Phone Number: | 6505732222 |
| Business Fax Number: | |
| Mailing Address: | 505 S Kinney Ave, MOUNT PLEASANT |
| State: | MI |
| Postal Code: | 488582710 |
| Phone Number: | 9894002252 |
| Fax Number: | |
| NPI Enumeration Date: | 04/03/2012 |
| NPI Last Update Date: | 04/03/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 1210526 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |