Provider Demographics
NPI:1336542638
Name:MELIA, KATHLEEN MCINTOSH (DPT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MCINTOSH
Last Name:MELIA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:MCINTOSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1162B GORGAS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94129-1406
Mailing Address - Country:US
Mailing Address - Phone:415-561-6655
Mailing Address - Fax:415-561-6650
Practice Address - Street 1:1162B GORGAS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94129-1406
Practice Address - Country:US
Practice Address - Phone:415-561-6655
Practice Address - Fax:415-561-6650
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist