Provider Demographics
NPI:1437827375
Name:RODKEY, MELISSA M (PT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:RODKEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31524 WINNERS CIR
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-4033
Mailing Address - Country:US
Mailing Address - Phone:440-258-2356
Mailing Address - Fax:
Practice Address - Street 1:31524 WINNERS CIR
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-4033
Practice Address - Country:US
Practice Address - Phone:440-258-2356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-04
Last Update Date:2021-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH8911225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty