Provider Demographics
NPI:1598356677
Name:BAUER, MELISSA ANN (MS LAT ATC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:BAUER
Suffix:
Gender:F
Credentials:MS LAT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 RIDGESIDE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-1817
Mailing Address - Country:US
Mailing Address - Phone:412-721-9748
Mailing Address - Fax:
Practice Address - Street 1:107 RIDGESIDE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-1817
Practice Address - Country:US
Practice Address - Phone:412-721-9748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART001080A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer