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Individual

MRS. MAVIS JOY MELTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T

Contact information

Practice address
1280 CHANDLER DR, SPOONER, WI 54801-2202
(715) 939-1745
(715) 939-1557
Mailing address
1280 CHANDLER DR, SPOONER, WI 54801-2202
(715) 939-1745
(715) 939-1557

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6410024
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40364300
WI
Enumeration date
03/06/2007
Last updated
12/08/2016
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