Provider Demographics
NPI:1023351699
Name:MATTHEWS, MELANIE FLORENCE
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:FLORENCE
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9149 SPARKLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-6351
Mailing Address - Country:US
Mailing Address - Phone:702-517-2478
Mailing Address - Fax:
Practice Address - Street 1:9149 SPARKLEWOOD CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6351
Practice Address - Country:US
Practice Address - Phone:702-517-2478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner