Provider Demographics
NPI:1265473235
Name:RICHENDOLLAR, MELISSA LYNN (ATC)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:LYNN
Last Name:RICHENDOLLAR
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5137 COUNTY ROAD 550
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:OH
Mailing Address - Zip Code:45628-9759
Mailing Address - Country:US
Mailing Address - Phone:740-253-5767
Mailing Address - Fax:
Practice Address - Street 1:3367 COUNTY ROAD 550
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:OH
Practice Address - Zip Code:45628-9503
Practice Address - Country:US
Practice Address - Phone:740-253-5767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0010942255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer