Provider Demographics
NPI:1356481618
Name:MAEGLE, MELISSA J (PT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:J
Last Name:MAEGLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:J
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:401 LOCUST ST
Mailing Address - Street 2:2A
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-3954
Mailing Address - Country:US
Mailing Address - Phone:412-299-0704
Mailing Address - Fax:412-299-0716
Practice Address - Street 1:401 LOCUST ST
Practice Address - Street 2:2A
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-3954
Practice Address - Country:US
Practice Address - Phone:412-299-0704
Practice Address - Fax:412-299-0716
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017345225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist