Provider Demographics
NPI:1417033515
Name:MELTON, JOHN DEAN (PT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DEAN
Last Name:MELTON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 ALAMO DR
Mailing Address - Street 2:
Mailing Address - City:SALUDA
Mailing Address - State:SC
Mailing Address - Zip Code:29138-1668
Mailing Address - Country:US
Mailing Address - Phone:864-445-9450
Mailing Address - Fax:
Practice Address - Street 1:404 BATESBURG HWY
Practice Address - Street 2:
Practice Address - City:SALUDA
Practice Address - State:SC
Practice Address - Zip Code:29138-1712
Practice Address - Country:US
Practice Address - Phone:864-445-4166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2293225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist