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NPI Code Detail

MEDICARE: MRS. MELANIE DAWN PHILLIPS OTR

MEDICARE:  MRS. MELANIE DAWN PHILLIPS  OTR
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
1225X00000XOccupational Therapist102852MN

General Provider Information

NPI Number : 1326249251
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELANIE DAWN PHILLIPS OTR
Provider Business Mailing Address
First Line : 30610 ELM ST
Second Line :
City : LINDSTROM
State : MN
Zip : 55045-9306
Country : US
Telephone Number : 651-213-6187
Fax Number :
Provider Business Practice Location Address
First Line : 1101 BLACK OAK DR
Second Line :
City : NEW BRIGHTON
State : MN
Zip : 55112-8400
Country : US
Telephone Number : 651-288-5246
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. MELANIE DAWN PHILLIPS OTR” Practice Location

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