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Individual

MELISSA ANN LEWELLEN

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
5265 JERSEY RIDGE ROAD, DAVENPORT, IA 52807
(563) 441-5763
(563) 355-0107
Mailing address
5265 JERSEY RIDGE ROAD, DAVENPORT, IA 52807
(563) 441-5763
(563) 355-0107

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
03380
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
46072
BCBS
IA
Enumeration date
05/12/2006
Last updated
07/08/2007
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