Individual
MRS. MELISSA MARIE WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
309 RUHLE RD S, BALLSTON LAKE, NY 12019-1031
(518) 899-2956
(518) 899-2956
Mailing address
309 RUHLE RD S, BALLSTON LAKE, NY 12019-1031
(518) 899-2956
(518) 899-2956
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
018504-1
NY
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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