Most Relevant Information
Provider Data
| NPI Number: | 1003411364 |
| Provider Name: | MELANIE KORNBLUM OTR/L |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 2014001334 |
Most Important Dates
| Enumeration Date: | 12/03/2020 |
| Last Updated: | 12/03/2020 |
Provider Practice Location
1 MERAMEC BLUFFS DR
BALLWIN
MO
630213309
Practice Location Phone/Fax
| Phone: | 6368610600 |
| Fax: |
Provider Mailing Location
59 CHRISTINA DR
PEVELY
MO
630701645
Provider Mailing Phone/Fax
| Phone: | 3147692659 |
| Fax: |