Provider Demographics
NPI:1518745900
Name:WOMAC, MELIA (PT)
Entity Type:Individual
Prefix:
First Name:MELIA
Middle Name:
Last Name:WOMAC
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MELIA
Other - Middle Name:
Other - Last Name:PINNIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:311 W LAMBERT LN
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37803-6110
Mailing Address - Country:US
Mailing Address - Phone:336-469-0747
Mailing Address - Fax:
Practice Address - Street 1:311 W LAMBERT LN
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37803-6110
Practice Address - Country:US
Practice Address - Phone:336-469-0747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN88072251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics