Healthcare Provider Details

I. General information

NPI: 1912113952
Provider Name (Legal Business Name): MELANIE R SEELEY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 01/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 KAUPAKALUA RD
HAIKU HI
96708-5915
US

IV. Provider business mailing address

PO BOX 882
MAKAWAO HI
96768-0882
US

V. Phone/Fax

Practice location:
  • Phone: 808-344-1970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number1927
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: