| NPI | 1205377967 |
|---|---|
| Former Name | MELISSA ANN WATERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT027559) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT003658) |
| 225100000X Physical Therapist (Licence: MN 10518) | |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2023-03-17 |