Healthcare Provider Details

I. General information

NPI: 1316278864
Provider Name (Legal Business Name): MELISSA A MAHER DC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2010
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 W ATLANTIC AVE
DELRAY BEACH FL
33445-4669
US

IV. Provider business mailing address

16244 S MILITARY TRL STE 460
DELRAY BEACH FL
33484-6532
US

V. Phone/Fax

Practice location:
  • Phone: 561-894-7010
  • Fax: 561-270-2721
Mailing address:
  • Phone: 561-894-7010
  • Fax: 561-270-2721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH8601
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT19642
License Number StateFL

VIII. Authorized Official

Name: MR. STEVEN S MAHER
Title or Position: VP
Credential:
Phone: 561-894-7010