Provider Demographics
NPI:1114051109
Name:ARSENEAUX, MELISSA COPP (PT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:COPP
Last Name:ARSENEAUX
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 1:1688 FUQUAY RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8127
Mailing Address - Country:US
Mailing Address - Phone:812-480-0715
Mailing Address - Fax:812-490-6417
Practice Address - Street 1:1688 FUQUAY RD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8127
Practice Address - Country:US
Practice Address - Phone:812-480-0715
Practice Address - Fax:812-490-6417
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05001796A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist