Healthcare Provider Details

I. General information

NPI: 1548234008
Provider Name (Legal Business Name): MELISSA LYNNE SUPINSKI DPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 N WESTFIELD ST
FEEDING HILLS MA
01030-1606
US

IV. Provider business mailing address

60 N WESTFIELD ST
FEEDING HILLS MA
01030-1679
US

V. Phone/Fax

Practice location:
  • Phone: 413-786-8908
  • Fax: 413-786-0185
Mailing address:
  • Phone: 413-786-8908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17464
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: