Provider Demographics
NPI:1477861524
Name:GARRETT, MELANIE GALLA (PT)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:GALLA
Last Name:GARRETT
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 1:1040 GULF BREEZE PKWY
Mailing Address - Street 2:STE 101
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561-7809
Mailing Address - Country:US
Mailing Address - Phone:850-934-2180
Mailing Address - Fax:850-934-4181
Practice Address - Street 1:669 S. MCKENZIE ST
Practice Address - Street 2:STE 103
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-1969
Practice Address - Country:US
Practice Address - Phone:850-934-2180
Practice Address - Fax:850-934-4181
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18948225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist