Provider Demographics
NPI:1497580336
Name:DUFF, MELISSA DAWN (PT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:DAWN
Last Name:DUFF
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:DAWN
Other - Last Name:BADGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9379 COUNTY ROAD 292
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44654-9062
Mailing Address - Country:US
Mailing Address - Phone:330-407-9953
Mailing Address - Fax:
Practice Address - Street 1:8001 TOWNSHIP ROAD 574
Practice Address - Street 2:
Practice Address - City:HOLMESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44633-9751
Practice Address - Country:US
Practice Address - Phone:330-674-8045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT012234225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist