Individual
MELISSA D EDMONDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1204 HIGHWAY 60, SOCORRO, NM 87801-3914
(575) 838-4690
(575) 838-4689
Mailing address
1204 HIGHWAY 60, SOCORRO, NM 87801-3914
(575) 838-4690
(575) 838-4689
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4287
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4287
NM STATE LICENSE
NM
Enumeration date
04/19/2013
Last updated
04/19/2013
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