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General NPI Number Information
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NPI Number | 1295168359
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Entity Type | Individual
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Provider Name | MELANIE DENICE COBB PT, DPT, CSCS
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Gender | Female
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Dates
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Enumeration Date | 08/13/2013
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 5568 GENERAL WASHINGTON DR STE A203
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City | ALEXANDRIA
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State | VA
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Zip | 22312-2465
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Country | US
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Telephone | 703-663-8864
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Fax |
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Provider Business Mailing Address
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Address Line | 292 SHADOW MOSS CIR
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City | RICHMOND HILL
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State | GA
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Zip | 31324-7322
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Country | US
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Telephone | 956-573-6276
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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 | 9776
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT018258
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305210080
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License Number State | VA
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