Provider Demographics
NPI:1457634818
Name:MYER, MELISSA BRIANA (DPT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:BRIANA
Last Name:MYER
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 1:1801 PINE ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-0165
Mailing Address - Country:US
Mailing Address - Phone:334-262-6161
Mailing Address - Fax:334-834-1705
Practice Address - Street 1:1801 PINE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-0165
Practice Address - Country:US
Practice Address - Phone:334-262-6161
Practice Address - Fax:334-834-1705
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH6285225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist