Provider Demographics
NPI:1437720760
Name:BRIX, MELISSA DIANE (DPT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:DIANE
Last Name:BRIX
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111965 WINTERBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-4384
Mailing Address - Country:US
Mailing Address - Phone:715-305-0994
Mailing Address - Fax:
Practice Address - Street 1:2901 HOOVER RD
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-5608
Practice Address - Country:US
Practice Address - Phone:715-254-3936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15512-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist