Provider Demographics
NPI:1871699280
Name:FOX, MELISSA N (PT)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:N
Last Name:FOX
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2335 YUMA DR
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-8766
Mailing Address - Country:US
Mailing Address - Phone:419-447-7203
Mailing Address - Fax:419-447-5577
Practice Address - Street 1:289 LAFAYETTE ST
Practice Address - Street 2:SUITES L & M
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-8673
Practice Address - Country:US
Practice Address - Phone:740-845-0925
Practice Address - Fax:740-845-0959
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH008533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist