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Individual

MELINDA SHANE CANTRELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
1069 SCHOOL HOUSE ROAD, BIG ROCK, VA 24603
(276) 530-7260
Mailing address
1069 SCHOOLHOUSE ROAD, BIG ROCK, VA 24603

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119003456
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1184774598
VA
Enumeration date
03/20/2013
Last updated
03/20/2013
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