Individual
JOEL BENNETT MELVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
16 HAYDEN AVE, LEXINGTON, MA 02421-7929
(781) 744-7060
(781) 744-7069
Mailing address
41 MALL RD, BURLINGTON, MA 01805-0001
(781) 744-8645
(781) 744-5215
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
18732
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110083104A
—
MA
Enumeration date
08/03/2009
Last updated
11/30/2010
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