Provider Demographics
NPI:1245418714
Name:THOMAS, MELISSA GAIL (EDD, ATC)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:GAIL
Last Name:THOMAS
Suffix:
Gender:F
Credentials:EDD, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5735 COLLEGE PKWY
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36613-2842
Mailing Address - Country:US
Mailing Address - Phone:251-442-2561
Mailing Address - Fax:
Practice Address - Street 1:5735 COLLEGE PKWY
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36613-2842
Practice Address - Country:US
Practice Address - Phone:251-442-2324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4352255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer