Provider Demographics
NPI:1912217191
Name:CHAUDOIN, MELISSA ESTERLINE (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ESTERLINE
Last Name:CHAUDOIN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:ESTERLINE
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:1220 WOODRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17057-3184
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 E KING ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-3272
Practice Address - Country:US
Practice Address - Phone:717-293-7279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019987225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist