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NPI Code Detail

MEDICARE: MELISSA A. MCKNIGHT MPT

MEDICARE: MELISSA A. MCKNIGHT MPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5519OR
2225100000XPhysical TherapistPT 27654CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2PENDINGOTHERCAPALMETTO GBA

General Provider Information

NPI Number : 1083706451
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA A. MCKNIGHT MPT
Provider Business Mailing Address
First Line : 12842 OLIVE ST
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92845-2633
Country : US
Telephone Number : 541-844-4381
Fax Number :
Provider Business Practice Location Address
First Line : 6080 CENTER DR FL 6
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-9205
Country : US
Telephone Number : 888-859-0145
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2006
Last Update Date : 11/09/2022

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