Individual
MRS. MELINDA NYGREN PIERCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, MS, CEEAA
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
070002515
IL
2251X0800X
Orthopedic Physical Therapist
070002515
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL 2699-004
MEDICARE PTAN
IL
Enumeration date
04/18/2007
Last updated
06/06/2013
Update your record
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