| NPI | 1538477427 | 
|---|---|
| Former Name | MELISSA APRIL MCKEON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: SC 6273) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 19022) | 
| Enumeration Date | 2010-09-14 | 
| Last Update Date | 2015-10-20 |