Provider Demographics
NPI:1013541556
Name:LOW, MELANIE GRACE (BSC (PHYSIOTHERAPY))
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:GRACE
Last Name:LOW
Suffix:
Gender:F
Credentials:BSC (PHYSIOTHERAPY)
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 1148
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95015-1148
Mailing Address - Country:US
Mailing Address - Phone:650-823-3349
Mailing Address - Fax:
Practice Address - Street 1:14103 WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1835
Practice Address - Country:US
Practice Address - Phone:408-868-5577
Practice Address - Fax:408-841-7205
Is Sole Proprietor?:No
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA297946225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist