Individual
MELISSA S NORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1330 APPLE VALLEY DR, O FALLON, MO 63366-3473
(314) 403-4121
Mailing address
1330 APPLE VALLEY DR, O FALLON, MO 63366-3473
(314) 403-4121
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
106972
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106972
PT LICENSE
MO
Enumeration date
01/30/2019
Last updated
01/30/2019
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