Provider Demographics
NPI:1902058167
Name:FORD, MELISSA A (PT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:FORD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:955 W MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MOUNT JOY
Mailing Address - State:PA
Mailing Address - Zip Code:17552-1838
Mailing Address - Country:US
Mailing Address - Phone:717-492-9532
Mailing Address - Fax:717-492-9235
Practice Address - Street 1:955 W MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:MOUNT JOY
Practice Address - State:PA
Practice Address - Zip Code:17552-1838
Practice Address - Country:US
Practice Address - Phone:717-492-9532
Practice Address - Fax:717-492-9235
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPT007231L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist