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General NPI Number Information
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NPI Number | 1316545692
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Entity Type | Individual
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Provider Name | MELISSA MULLANEY PT
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Gender | Female
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Dates
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Enumeration Date | 10/09/2020
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Last Update Date | 10/09/2020
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Provider Practice Location Address
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Address Line | 2446 HIGHLAND AVE
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City | FALL RIVER
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State | MA
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Zip | 02720-4504
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Country | US
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Telephone | 508-679-0011
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Fax |
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Provider Business Mailing Address
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Address Line | 14 S COMMONS RD
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City | TIVERTON
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State | RI
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Zip | 02878-2793
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Country | US
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Telephone |
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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 | 7288
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License Number State | MA
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