Provider Demographics
NPI:1437383577
Name:HIGGINS, MELINDA LOUISE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:LOUISE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4303 NANEEN DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-3938
Mailing Address - Country:US
Mailing Address - Phone:502-554-2378
Mailing Address - Fax:
Practice Address - Street 1:10631 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-4349
Practice Address - Country:US
Practice Address - Phone:502-933-1777
Practice Address - Fax:502-933-7722
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005428225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist