Provider Demographics
NPI:1205239548
Name:PAULL, MELANI (DPT)
Entity type:Individual
Prefix:
First Name:MELANI
Middle Name:
Last Name:PAULL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14727 TIMBERBLUFF DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5575
Mailing Address - Country:US
Mailing Address - Phone:314-359-9007
Mailing Address - Fax:
Practice Address - Street 1:425 N NEW BALLAS RD STE 295
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6853
Practice Address - Country:US
Practice Address - Phone:314-993-7035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-01
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014019893225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist