Provider Demographics
NPI:1619177953
Name:DENNIS, MELANIE MARIE (MSPT)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:MARIE
Last Name:DENNIS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MRS
Other - First Name:MELANIE
Other - Middle Name:MARIE
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:207 PINE CREST VILLAGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:PINE GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17963
Mailing Address - Country:US
Mailing Address - Phone:570-695-3493
Mailing Address - Fax:570-695-2264
Practice Address - Street 1:207 PINE CREST VILLAGE DRIVE
Practice Address - Street 2:
Practice Address - City:PINE GROVE
Practice Address - State:PA
Practice Address - Zip Code:17963
Practice Address - Country:US
Practice Address - Phone:570-695-3493
Practice Address - Fax:570-695-2264
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist