Provider Demographics
NPI:1760523864
Name:ESCOBAR, MELISSA L (MS PT)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:L
Last Name:ESCOBAR
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Gender:F
Credentials:MS PT
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Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-0456
Mailing Address - Country:US
Mailing Address - Phone:401-371-2890
Mailing Address - Fax:401-371-2892
Practice Address - Street 1:1452 BRONCO HIGHWAY
Practice Address - Street 2:SUITE 3
Practice Address - City:OAKLAND
Practice Address - State:RI
Practice Address - Zip Code:02858-1034
Practice Address - Country:US
Practice Address - Phone:401-371-2890
Practice Address - Fax:401-371-2892
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2011-03-02
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Provider Licenses
StateLicense IDTaxonomies
RIPT01789225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist