Provider Demographics
NPI:1609085653
Name:VILLEGAS, MELANIE LOZANO (PT)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:LOZANO
Last Name:VILLEGAS
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 1:305 LINNIPPI TRL
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-3142
Mailing Address - Country:US
Mailing Address - Phone:570-567-4280
Mailing Address - Fax:
Practice Address - Street 1:1201 RURAL AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-1669
Practice Address - Country:US
Practice Address - Phone:570-323-4340
Practice Address - Fax:570-329-3083
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018391225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist