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NPI Code Detail

MEDICARE: MELISSA STOLL DPT

MEDICARE: MELISSA STOLL DPT
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 TherapistPT011624OH

General Provider Information

NPI Number : 1588789432
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA STOLL DPT
Provider Business Mailing Address
First Line : 1500 VINEYARD DR
Second Line : #302
City : BROADVIEW HEIGHTS
State : OH
Zip : 44147-3397
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 20265 EMERY RD
Second Line :
City : NORTH RANDALL
State : OH
Zip : 44128-4122
Country : US
Telephone Number : 216-584-2720
Fax Number : 216-475-6338
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 07/19/2010

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Directions to “ MELISSA STOLL DPT” Practice Location

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