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Individual

MELISSA JANE STAVRAKIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT, OCS

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002359
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2590290
OH
05
7301143000
WV
01
P00148738
RAILROAD MEDICARE
Enumeration date
07/31/2006
Last updated
05/24/2019
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