Provider Demographics
NPI:1699832246
Name:HOURIHAN, MELISSA JO (DPT)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:JO
Last Name:HOURIHAN
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 1:5301 W WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-1368
Mailing Address - Country:US
Mailing Address - Phone:602-670-6969
Mailing Address - Fax:
Practice Address - Street 1:7616 W THUNDERBIRD RD
Practice Address - Street 2:STE. 104
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-6081
Practice Address - Country:US
Practice Address - Phone:602-670-6969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ44052251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic