Individual
MS. MELISSA MAE WADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
118 RARDEN RD, PEEBLES, OH 45660-1049
(937) 587-9422
(937) 587-9522
Mailing address
118 RARDEN RD, PEEBLES, OH 45660-1049
(937) 587-9422
(937) 587-9522
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
PT005740
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31-1448551
TAX ID
OH
Enumeration date
10/06/2006
Last updated
07/02/2025
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