Provider Demographics
NPI:1376148577
Name:MELAMOR THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:MELAMOR THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:847-251-6495
Mailing Address - Street 1:3223 LAKE AVENUE UNIT 15-C
Mailing Address - Street 2:#175
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091
Mailing Address - Country:US
Mailing Address - Phone:847-251-6495
Mailing Address - Fax:888-975-1982
Practice Address - Street 1:621 LAPORTE AVE
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-2019
Practice Address - Country:US
Practice Address - Phone:847-251-6495
Practice Address - Fax:888-975-1982
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MELAMOR THERAPY SERVICES , INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency