Provider Demographics
NPI:1982920070
Name:ABERCROMBIE, MELISSA LEIGH (DPT)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:LEIGH
Last Name:ABERCROMBIE
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 1:1218 N DIVISION AVE
Mailing Address - Street 2:STE. 102
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-5054
Mailing Address - Country:US
Mailing Address - Phone:208-255-6693
Mailing Address - Fax:
Practice Address - Street 1:1218 N DIVISION AVE
Practice Address - Street 2:STE. 102
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-5054
Practice Address - Country:US
Practice Address - Phone:208-255-6693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist