Provider Demographics
NPI:1790715696
Name:MELVIN, JAMES M (PT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:MELVIN
Suffix:
Gender:M
Credentials:PT
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 2250
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96160-2250
Mailing Address - Country:US
Mailing Address - Phone:530-582-9415
Mailing Address - Fax:
Practice Address - Street 1:1664 N VIRGINIA ST # S.274
Practice Address - Street 2:MOTION ANALYSIS LAB,LOMBARDI BUILDING, U.N.R.
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89557-0001
Practice Address - Country:US
Practice Address - Phone:775-784-4041
Practice Address - Fax:775-784-6425
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0621225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist