Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 070.016506 | IL |
NPI | 1104056571 |
---|---|
Provider Name | Ms. Abbey Louise Melling |
First Address | Chicago, IL 60654-8803 |
Second Address | Chicago, IL 60654-8803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2009 |
Last Update Date | 20/07/2009 |