Healthcare Provider Details

I. General information

NPI: 1235808577
Provider Name (Legal Business Name): MELISSA METZKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 E POMFRET ST
CARLISLE PA
17013-2579
US

IV. Provider business mailing address

290 E POMFRET ST
CARLISLE PA
17013-2579
US

V. Phone/Fax

Practice location:
  • Phone: 171-245-0400
  • Fax: 717-243-5688
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT029691
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: