Provider Demographics
NPI:1083944763
Name:BROWN, MELISSA MAIDLOW (MPT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:MAIDLOW
Last Name:BROWN
Suffix:
Gender:F
Credentials:MPT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 BRONSON BLVD
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-3134
Mailing Address - Country:US
Mailing Address - Phone:269-464-0044
Mailing Address - Fax:844-906-2440
Practice Address - Street 1:4030 BRONSON BLVD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-3134
Practice Address - Country:US
Practice Address - Phone:269-464-0044
Practice Address - Fax:844-906-2440
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-02
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL1391211225100000X
MI5501010759225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist