Provider Demographics
NPI:1740167485
Name:MELANSON, HAYDEN (PT, DPT)
Entity type:Individual
Prefix:
First Name:HAYDEN
Middle Name:
Last Name:MELANSON
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:768 SABRE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70611-4628
Mailing Address - Country:US
Mailing Address - Phone:337-499-4259
Mailing Address - Fax:
Practice Address - Street 1:1714 WOLF CIR
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-2353
Practice Address - Country:US
Practice Address - Phone:512-718-3575
Practice Address - Fax:337-508-2506
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12177225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist