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Individual

MELISSA M SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
22245 ANTHEM PL, CHIGIAK, AK 99567-7020
(907) 545-0137
(907) 688-0367
Mailing address
PO BOX 671904, CHUGIAK, AK 99567-1904
(907) 545-0137
(907) 688-0367

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
499
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1020986
AK
Enumeration date
11/04/2006
Last updated
12/12/2013
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