Provider Demographics
NPI:1407472160
Name:HARVILLE, MELISSA SHEA (LPTA)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:SHEA
Last Name:HARVILLE
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 GIBSON FARM LN
Mailing Address - Street 2:
Mailing Address - City:RAMER
Mailing Address - State:AL
Mailing Address - Zip Code:36069-6540
Mailing Address - Country:US
Mailing Address - Phone:334-850-4140
Mailing Address - Fax:
Practice Address - Street 1:520 S HULL ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36104-4610
Practice Address - Country:US
Practice Address - Phone:334-834-2920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTA8464225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant