Provider Demographics
NPI:1477146579
Name:WHALEY, MELISSA (DPT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:WHALEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:MACON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1302 SUNSET AVENUE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-3824
Mailing Address - Country:US
Mailing Address - Phone:910-490-1269
Mailing Address - Fax:910-490-1317
Practice Address - Street 1:1302 SUNSET AVENUE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-3824
Practice Address - Country:US
Practice Address - Phone:910-490-1269
Practice Address - Fax:910-490-1317
Is Sole Proprietor?:No
Enumeration Date:2021-02-19
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist