Individual
MELISSA DAWN THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
301 E BROADWAY ST, ALTUS, OK 73521-5507
(405) 609-3675
(800) 506-3795
Mailing address
700 NW 7TH ST, SUITE 304, OKLAHOMA CITY, OK 73102-1212
(405) 609-3675
(800) 506-3795
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4298
OK
Other
Enumeration date
05/10/2010
Last updated
07/11/2013
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