Healthcare Provider Details

I. General information

NPI: 1295703817
Provider Name (Legal Business Name): MELANIE HUNDLING DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELANIE LLER DPT

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 LINCOLN WAY
AMES IA
50014-7595
US

IV. Provider business mailing address

11879 BIRCH AVE
BREDA IA
51436-8523
US

V. Phone/Fax

Practice location:
  • Phone: 515-663-4824
  • Fax: 515-663-4860
Mailing address:
  • Phone: 712-673-4346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number03870
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: