Organization
SOUTHERN OHIO SPORTS MEDICINE AND PHYSICAL THERAPY
Active
Other names
Southern Ohio Sports Medicine and Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA MAE WADDELL PT (PHYSICAL THERAPIST)
(937) 587-9422
Entity
Organization
Contact information
Practice address
118 RARDEN RD, PEEBLES, OH 45660-1049
(937) 587-9422
(937) 587-9522
Mailing address
118 RARDEN RD, PEEBLES, OH 45660-1049
(937) 587-9422
(937) 587-9522
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT 5740
OH
Other
Enumeration date
11/30/2010
Last updated
11/30/2010
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