Healthcare Provider Details

I. General information

NPI: 1730118191
Provider Name (Legal Business Name): MELISSA JOYE MCCOMBS PTA, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 HWY 17 BUS SOUTH UNIT F
SURFSIDE BEACH SC
29575
US

IV. Provider business mailing address

1959 MAPLE HILL RD
HINSDALE NY
14743-9752
US

V. Phone/Fax

Practice location:
  • Phone: 843-238-9542
  • Fax: 843-477-1280
Mailing address:
  • Phone: 716-307-7142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number3756
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: