Provider Demographics
NPI:1760668065
Name:BENINGHOF, MELISSA VIRGINIA (MSPT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:VIRGINIA
Last Name:BENINGHOF
Suffix:
Gender:F
Credentials:MSPT
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 495
Mailing Address - Street 2:
Mailing Address - City:MONUMENT BEACH
Mailing Address - State:MA
Mailing Address - Zip Code:02553-0495
Mailing Address - Country:US
Mailing Address - Phone:407-579-1728
Mailing Address - Fax:508-495-7606
Practice Address - Street 1:100 TER HEUN DRIVE
Practice Address - Street 2:FALMOUTH HOSPITAL OUTPATIENT REHABILITATION SERVICES
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540
Practice Address - Country:US
Practice Address - Phone:508-495-7671
Practice Address - Fax:508-495-7606
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17561225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist