Provider Demographics
NPI:1306419270
Name:MELISA T CROSBY, PT P.A.
Entity Type:Organization
Organization Name:MELISA T CROSBY, PT P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-684-9110
Mailing Address - Street 1:195 S US HIGHWAY 17 STE 1
Mailing Address - Street 2:
Mailing Address - City:EAST PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32131-4042
Mailing Address - Country:US
Mailing Address - Phone:386-385-3598
Mailing Address - Fax:386-684-9255
Practice Address - Street 1:195 S US HIGHWAY 17 STE 1
Practice Address - Street 2:
Practice Address - City:EAST PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32131-4042
Practice Address - Country:US
Practice Address - Phone:386-385-3598
Practice Address - Fax:386-684-9255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy