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Individual

MRS. MELISSA DAWN LEDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPT

Contact information

Practice address
US 52 STONECOAL SUITE 2, CRUM, WV 25669
(304) 842-0307
(304) 842-0315
Mailing address
1400 JOHNSON AVE, SUITE 4S, BRIDGEPORT, WV 26330-1063
(304) 842-0307
(304) 842-0315

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002607
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001958593
MOUNTAIN STATE BCBS
WV
01
1071301
WORKERS COMP, BRICKSTREET
WV
05
3810011332
WV
01
7415904
AETNA
WV
Enumeration date
01/30/2007
Last updated
10/03/2008
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