Individual
MELANIE JANE SHANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4523 FAIRLAWN PASS, FORT WAYNE, IN 46815-6039
(765) 618-3464
Mailing address
4523 FAIRLAWN PASS, FORT WAYNE, IN 46815-6039
(765) 618-3464
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
32002236A
IN
Other
Enumeration date
06/30/2013
Last updated
06/30/2013
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