Individual
MRS. MELISSA ELIZABETH MALCOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4107 HOHE AVE, HOMER, AK 99603
(907) 235-0687
Mailing address
4107 HOHE AVE, HOMER, AK 99603
(907) 235-0687
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
119695
AK
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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