Organization
FUNCTIONAL PATHWAYS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELLISA FANNING OT (OCCUPATIONAL THERAPIST)
(256) 684-3368
Entity
Organization
Contact information
Practice address
12000 TURNMEYER DR SE, HUNTSVILLE, AL 35803-3358
(256) 684-3368
Mailing address
717 MARINA PARK DR SE, HUNTSVILLE, AL 35803-3034
(256) 684-3368
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2394
AL
Other
Enumeration date
05/04/2018
Last updated
05/04/2018
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