Provider Demographics
NPI:1326426461
Name:LIKE, MELINDA LEE (CRT)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:LEE
Last Name:LIKE
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:
Other - Last Name:WALLACE (MAIDEN)
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:713 NORTHWAY DRIVE
Mailing Address - Street 2:(PROCARE HOME MEDICAL)
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508
Mailing Address - Country:US
Mailing Address - Phone:907-274-0770
Mailing Address - Fax:907-274-0773
Practice Address - Street 1:713 NORTHWAY DRIVE
Practice Address - Street 2:(PROCARE HOME MEDICAL)
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-274-0770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CRT227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified