| NPI | 1235562273 |
|---|---|
| Former Name | MELISSA MARIE PARKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 6838) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 13915) |
| 225100000X Physical Therapist (Licence: FL 19950) | |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2013-08-13 |