Provider Demographics
NPI:1437201167
Name:POHORENCE, MELISSA ANN (ATC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:POHORENCE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 156
Mailing Address - Street 2:215 NORTH WASHINGTON STREET UNIT 8
Mailing Address - City:MANCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48158-0156
Mailing Address - Country:US
Mailing Address - Phone:734-476-2564
Mailing Address - Fax:
Practice Address - Street 1:799 N HEWITT RD
Practice Address - Street 2:142 CONVOCATION CENTER
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1701
Practice Address - Country:US
Practice Address - Phone:734-487-5179
Practice Address - Fax:734-487-5173
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer