Provider Demographics
NPI:1861632424
Name:JONES, MELISSA SC (DPT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:SC
Last Name:JONES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:SUE
Other - Last Name:CHENELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:8R SUNSET ROAD
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-4355
Mailing Address - Country:US
Mailing Address - Phone:978-491-8434
Mailing Address - Fax:
Practice Address - Street 1:8R SUNSET ROAD
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-4355
Practice Address - Country:US
Practice Address - Phone:978-491-8434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18184225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist