Individual
MELISSA M BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
424 KIMBARK ST, LONGMONT, CO 80501-5526
(303) 427-5302
Mailing address
56 BOUNTIFUL AVE, LONGMONT, CO 80501-8819
(970) 368-0992
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTA.0014944
CO
Other
Enumeration date
11/19/2021
Last updated
11/19/2021
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