Provider Demographics
NPI:1649642869
Name:TAYLOR THURMOND, MELANIE (DPT)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:
Last Name:TAYLOR THURMOND
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:153 DANCING BEAR BLVD
Mailing Address - Street 2:APT 2
Mailing Address - City:WINNEMUCCA
Mailing Address - State:NV
Mailing Address - Zip Code:89445-4822
Mailing Address - Country:US
Mailing Address - Phone:989-884-1179
Mailing Address - Fax:
Practice Address - Street 1:325 HANSON ST
Practice Address - Street 2:
Practice Address - City:WINNEMUCCA
Practice Address - State:NV
Practice Address - Zip Code:89445-3607
Practice Address - Country:US
Practice Address - Phone:775-625-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-27
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3237225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV3237OtherNEVADA PROFESSIONAL LICENSE