Provider Demographics
NPI:1497371421
Name:MONKMAN, MELANIE SPICOLA
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:SPICOLA
Last Name:MONKMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:ELIZABETH
Other - Last Name:SPICOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6709 WARRINER WAY
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-8638
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 POLARIS PKWY STE 2600
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7995
Practice Address - Country:US
Practice Address - Phone:614-776-0970
Practice Address - Fax:614-212-4900
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT014891225100000X
OHPT020159225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist