Provider Demographics
NPI:1164668372
Name:FOLEY, MELISSA (PT, DPT, CSCS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:FOLEY
Suffix:
Gender:F
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 WENHAM ST
Mailing Address - Street 2:UNIT 2
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4153
Mailing Address - Country:US
Mailing Address - Phone:508-277-1984
Mailing Address - Fax:
Practice Address - Street 1:93 WENHAM ST
Practice Address - Street 2:UNIT 2
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-4153
Practice Address - Country:US
Practice Address - Phone:508-277-1984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-18
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18255225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist