Individual
MRS. MELODY T MATTOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2705 LEAPHART RD, WEST COLUMBIA, SC 29169-3335
(803) 926-5119
Mailing address
1053 CENTER ST, WEST COLUMBIA, SC 29169-6749
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
817
SC
Other
Enumeration date
01/16/2009
Last updated
01/16/2009
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