Individual
MELISSA P. WICHTOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
459 PHILO RD, ELMIRA, NY 14903-1051
(607) 739-3581
Mailing address
512 PINEWOOD CIR, ELMIRA, NY 14905-1113
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
011642-1
NY
Other
Enumeration date
09/08/2011
Last updated
09/08/2011
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