Healthcare Provider Details

I. General information

NPI: 1982637526
Provider Name (Legal Business Name): MELISSA L. BELCHER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA L. NUTTING PT

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 10/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FODEN RD, WEST SUITE 205
SOUTH PORTLAND ME
04106-2327
US

IV. Provider business mailing address

100 FORE ST 2ND FLOOR
PORTLAND ME
04101-4879
US

V. Phone/Fax

Practice location:
  • Phone: 207-780-8860
  • Fax: 207-780-8857
Mailing address:
  • Phone: 207-773-5778
  • Fax: 207-773-5773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 2533
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: