Provider Demographics
NPI:1265527808
Name:HARPER, MELODY HAMMONS (MPT)
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:HAMMONS
Last Name:HARPER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18780 HIGHWAY 22 STE E
Mailing Address - Street 2:
Mailing Address - City:MAUREPAS
Mailing Address - State:LA
Mailing Address - Zip Code:70449-3054
Mailing Address - Country:US
Mailing Address - Phone:225-698-1144
Mailing Address - Fax:225-698-1155
Practice Address - Street 1:18780 HIGHWAY 22 STE E
Practice Address - Street 2:
Practice Address - City:MAUREPAS
Practice Address - State:LA
Practice Address - Zip Code:70449-3054
Practice Address - Country:US
Practice Address - Phone:225-698-1144
Practice Address - Fax:225-698-1155
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06832225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4H591Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL ID
LA4H591CD04Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL/GROUP
LA4H591C492Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL/GROUP