Provider Demographics
NPI:1083126833
Name:QUIGLEY, MELISSA B (ATC, LAT, CSCS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:B
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:ATC, LAT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9502 THREE STONE LN
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-3395
Mailing Address - Country:US
Mailing Address - Phone:850-377-2052
Mailing Address - Fax:
Practice Address - Street 1:14555 FERN DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-5405
Practice Address - Country:US
Practice Address - Phone:713-251-3460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT31132255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer