Individual
MELISSA M IDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4100 FREEMANSBURG AVE, EASTON, PA 18045-5540
(610) 330-9030
Mailing address
4100 FREEMANSBURG AVE, EASTON, PA 18045-5540
(610) 330-9030
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE005407L
PA
Other
Enumeration date
10/15/2008
Last updated
10/15/2008
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