Provider Demographics
NPI:1376679977
Name:COMPTON, MELISSA K (CST SFA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:K
Last Name:COMPTON
Suffix:
Gender:F
Credentials:CST SFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 BLACKSTOCK RD
Mailing Address - Street 2:
Mailing Address - City:ENOREE
Mailing Address - State:SC
Mailing Address - Zip Code:29335-2702
Mailing Address - Country:US
Mailing Address - Phone:864-585-7538
Mailing Address - Fax:864-585-5883
Practice Address - Street 1:2741 BLACKSTOCK RD
Practice Address - Street 2:
Practice Address - City:ENOREE
Practice Address - State:SC
Practice Address - Zip Code:29335-2702
Practice Address - Country:US
Practice Address - Phone:864-585-7538
Practice Address - Fax:864-585-5883
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC064514246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty