Provider Demographics
NPI:1093926685
Name:MELTON, ERIN LORRAINE (DPT)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:LORRAINE
Last Name:MELTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3409 W SUTTON RD
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-9645
Mailing Address - Country:US
Mailing Address - Phone:810-797-4777
Mailing Address - Fax:
Practice Address - Street 1:2140 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-8305
Practice Address - Country:US
Practice Address - Phone:810-653-3962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013283225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist