Individual
DR. JENNIFER MELANCON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT,DPT,CKTP
Contact information
Practice address
3149 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-7209
(337) 706-3455
Mailing address
3149 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-7209
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
09043R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13792080
—
TX
Enumeration date
07/18/2012
Last updated
07/24/2017
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