Provider Demographics
NPI:1609257518
Name:HILDERBRAND, MELANNE (DPT)
Entity Type:Individual
Prefix:
First Name:MELANNE
Middle Name:
Last Name:HILDERBRAND
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:IA
Mailing Address - Zip Code:51541-5027
Mailing Address - Country:US
Mailing Address - Phone:402-707-5687
Mailing Address - Fax:
Practice Address - Street 1:1400 SENATE AVE
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:IA
Practice Address - Zip Code:51566-1271
Practice Address - Country:US
Practice Address - Phone:712-623-7163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA078633225100000X
SC7780225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist