Healthcare Provider Details

I. General information

NPI: 1104566322
Provider Name (Legal Business Name): MELISSA SCHREMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 03/29/2022
Certification Date: 03/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 RT-34
MARBLE HILL MO
63764
US

IV. Provider business mailing address

3295 N HIGHWAY 61
PERRYVILLE MO
63775-7440
US

V. Phone/Fax

Practice location:
  • Phone: 573-238-2614
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: