Provider Demographics
NPI:1164637583
Name:WINTERSWYK, MELINDA E (DPT, ATP)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:E
Last Name:WINTERSWYK
Suffix:
Gender:F
Credentials:DPT, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 PEPPERTREE DR
Mailing Address - Street 2:
Mailing Address - City:LA HABRA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:90631-8520
Mailing Address - Country:US
Mailing Address - Phone:562-619-4810
Mailing Address - Fax:
Practice Address - Street 1:200 W SANTA ANA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4134
Practice Address - Country:US
Practice Address - Phone:714-647-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA286072251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics