Provider Demographics
NPI:1063859908
Name:ARCILLA, MELANIE (PT)
Entity Type:Individual
Prefix:MISS
First Name:MELANIE
Middle Name:
Last Name:ARCILLA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 NEW GARDEN RD
Mailing Address - Street 2:1208
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2679
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1208 NEW GARDEN RD
Practice Address - Street 2:1208
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2679
Practice Address - Country:US
Practice Address - Phone:297-470-0336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-02
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12134225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist