Provider Demographics
NPI:1801315981
Name:WALZ, MELINDA (DPT)
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:
Last Name:WALZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SUGARTOWN RD.
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-3004
Mailing Address - Country:US
Mailing Address - Phone:484-582-0660
Mailing Address - Fax:484-582-0666
Practice Address - Street 1:215 SUGARTOWN RD.
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087
Practice Address - Country:US
Practice Address - Phone:484-582-0660
Practice Address - Fax:484-582-0666
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist