Provider Demographics
NPI:1649223660
Name:ESPY, MELISSA (DPT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ESPY
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:PO BOX 330541
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96733-0541
Mailing Address - Country:US
Mailing Address - Phone:808-249-8680
Mailing Address - Fax:
Practice Address - Street 1:830 KOLU ST
Practice Address - Street 2:SUITE #101
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1435
Practice Address - Country:US
Practice Address - Phone:808-249-8680
Practice Address - Fax:808-249-8650
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-2523225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist