Provider Demographics
NPI:1891933487
Name:HAWKINS, MELISSA DANIELLE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:DANIELLE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:708 WESTPORT RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-3819
Mailing Address - Country:US
Mailing Address - Phone:270-766-1213
Mailing Address - Fax:270-766-1115
Practice Address - Street 1:708 WESTPORT RD
Practice Address - Street 2:SUITE 201
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-3819
Practice Address - Country:US
Practice Address - Phone:270-766-1213
Practice Address - Fax:270-766-1115
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005388225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist