Individual
MR. MELISSA A. BRUNELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1822 MINERAL SPRING AVE, NORTH PROVIDENCE, RI 02904-8938
(401) 354-6700
(401) 354-6702
Mailing address
872 SMITHFIELD AVE, LINCOLN, RI 02865-3500
(401) 722-0012
(401) 722-0056
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22476-7
BCBS
RI
01
—
409454
BLUE CHIP
RI
Enumeration date
10/26/2006
Last updated
11/05/2007
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