Individual
MELISSA DEANNE FORTMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR
Contact information
Practice address
678 S COMMERCIAL ST, HARRISONVILLE, MO 64701-1653
(816) 380-3325
(816) 380-3044
Mailing address
6397 LEE HWY STE 300, CHATTANOOGA, TN 37421-2564
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
17-02184
KS
225X00000X
Occupational Therapist
Primary
2003021891
MO
Other
Enumeration date
01/20/2011
Last updated
10/30/2017
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