Provider Demographics
NPI:1285865063
Name:SCHROEDER, MELINDA LEE (PT)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:LEE
Last Name:SCHROEDER
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 1:1800 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-1855
Mailing Address - Country:US
Mailing Address - Phone:614-324-2117
Mailing Address - Fax:
Practice Address - Street 1:1800 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-1855
Practice Address - Country:US
Practice Address - Phone:614-324-2117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6404225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist