=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275835548
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELANIE C. HOLDEN PT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/18/2010
-----------------------------------------------------
Last Update Date | 11/29/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 202 MAIN ST SUITE G2
-----------------------------------------------------
City | SALEM
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03079-3170
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-233-3484
-----------------------------------------------------
Fax | 603-894-0657
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16 POPLAR HILL RD
-----------------------------------------------------
City | PELHAM
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03076-2908
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-233-3484
-----------------------------------------------------
Fax | 603-894-0657
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 1579
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------