Most Relevant Information
Provider Data
| NPI Number: | 1003068693 |
| Provider Name: | MELISSA M IDE PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | TE005407L |
Most Important Dates
| Enumeration Date: | 10/15/2008 |
| Last Updated: | 10/15/2008 |
Provider Practice Location
4100 FREEMANSBURG AVE
EASTON
PA
180455540
Practice Location Phone/Fax
| Phone: | 6103309030 |
| Fax: |
Provider Mailing Location
4100 FREEMANSBURG AVE
EASTON
PA
180455540
Provider Mailing Phone/Fax
| Phone: | 6103309030 |
| Fax: |