Individual
EMMA BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
567 N 5TH ST, TERRE HAUTE, IN 47809-1903
(616) 292-9228
Mailing address
4915 TIAMO LN NE, ROCKFORD, MI 49341-7714
(616) 292-9228
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/28/2026
Last updated
01/28/2026
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