Individual
MELISSA R LACOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH4526
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003819608
GROUP NPI
AL
01
—
529917620
MEDICAID GROUP
AL
01
—
CK8719
MEDICARE RAILROAD
AL
01
—
K531
MEDICARE GROUP
AL
Enumeration date
02/28/2008
Last updated
02/28/2008
Update your record
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