Provider Demographics
NPI:1467863720
Name:RAHMSDORF, MELISSA A
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:RAHMSDORF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GREAT MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-3819
Mailing Address - Country:US
Mailing Address - Phone:203-313-2629
Mailing Address - Fax:
Practice Address - Street 1:1920 OLD SPRINGVILLE RD
Practice Address - Street 2:
Practice Address - City:CENTER POINT
Practice Address - State:AL
Practice Address - Zip Code:35215-5858
Practice Address - Country:US
Practice Address - Phone:800-854-4589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24659225100000X
NCP14558225100000X
CT009951225100000X
VA2305208376225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist