Provider Demographics
NPI:1104017664
Name:KUESTER, MELISSA HUTSON (DPT)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:HUTSON
Last Name:KUESTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:HUTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:445 SAVANNAH HWY
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7207
Mailing Address - Country:US
Mailing Address - Phone:843-766-2121
Mailing Address - Fax:843-766-8644
Practice Address - Street 1:445 SAVANNAH HWY
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7207
Practice Address - Country:US
Practice Address - Phone:843-766-2121
Practice Address - Fax:843-766-8644
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ345587935Medicare PIN