Individual
EDWIN MELVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12221 E 51ST ST STE A, TULSA, OK 74146-6216
(918) 249-0623
Mailing address
9224 S 95TH EAST AVE, TULSA, OK 74133-5600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3609
LICENSE#
OK
Enumeration date
03/30/2007
Last updated
07/08/2007
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