Provider Demographics
NPI:1013986454
Name:JONES, MELISSA MARIE (ATC)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4328 NUTMEG LN
Mailing Address - Street 2:211
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1167
Mailing Address - Country:US
Mailing Address - Phone:612-396-1663
Mailing Address - Fax:
Practice Address - Street 1:4328 NUTMEG LN
Practice Address - Street 2:211
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1167
Practice Address - Country:US
Practice Address - Phone:612-396-1663
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist