Provider Demographics
NPI:1154349785
Name:KONTSIS, MELISSA L (PT)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:L
Last Name:KONTSIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:L
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6480 HARRISON AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-7961
Mailing Address - Country:US
Mailing Address - Phone:513-354-7777
Mailing Address - Fax:513-354-7778
Practice Address - Street 1:6480 HARRISON AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-7961
Practice Address - Country:US
Practice Address - Phone:513-354-7777
Practice Address - Fax:513-354-7778
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-005398225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000483078OtherANTHEM
OH415835OtherWELLCARE
OHP00340677OtherMEDICARE RAILROAD
OH2689336Medicaid
OHKO4186232Medicare PIN