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General NPI Number Information
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NPI Number | 1417033515
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Entity Type | Individual
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Provider Name | JOHN DEAN MELTON P.T.
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Gender | Male
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 404 BATESBURG HWY
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City | SALUDA
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State | SC
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Zip | 29138-1712
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Country | US
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Telephone | 864-445-4166
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Fax |
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Provider Business Mailing Address
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Address Line | 121 ALAMO DR
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City | SALUDA
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State | SC
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Zip | 29138-1668
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Country | US
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Telephone | 864-445-9450
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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 | 2293
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License Number State | SC
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