Provider Demographics
NPI:1013141647
Name:DUPREE, MELISSA ROSE (DPT)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:ROSE
Last Name:DUPREE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 PINE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-0953
Mailing Address - Country:US
Mailing Address - Phone:516-532-8699
Mailing Address - Fax:
Practice Address - Street 1:2064 AYRSLEY TOWN BLVD UNIT A
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-4221
Practice Address - Country:US
Practice Address - Phone:980-939-1580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC151682251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic