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General NPI Number Information
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NPI Number | 1013541556
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Entity Type | Individual
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Provider Name | MELANIE GRACE LOW BSC (PHYSIOTHERAPY)
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Gender | Female
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Dates
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Enumeration Date | 02/24/2020
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 14103 WINCHESTER BLVD
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City | LOS GATOS
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State | CA
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Zip | 95032-1835
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Country | US
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Telephone | 408-868-5577
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Fax | 408-841-7205
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Provider Business Mailing Address
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Address Line | PO BOX 1148
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City | CUPERTINO
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State | CA
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Zip | 95015-1148
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Country | US
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Telephone | 650-823-3349
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 297946
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License Number State | CA
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