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Individual

MR. BENNETT G MELLING

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PT, MOMT

Contact information

Practice address
2425 NW PRAIRIE VIEW RD, PLATTE CITY, MO 64079-7627
(816) 858-3250
(816) 858-3253
Mailing address
2425 NW PRAIRIE VIEW RD, PLATTE CITY, MO 64079-7627
(816) 858-3250
(816) 858-3253

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11-00945
KS
225100000X
Physical Therapist
Primary
R0462
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09945037
BLUE CROSS & BLUE SHIELD
MO
01
5093654
AETNA
MO
Enumeration date
01/17/2006
Last updated
07/08/2007
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