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General NPI Number Information
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NPI Number | 1629759923
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Entity Type | Individual
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Provider Name | MELANIE ZIAZIARIS
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Gender | Female
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Dates
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Enumeration Date | 07/28/2023
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Last Update Date | 07/28/2023
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Provider Practice Location Address
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Address Line | 940 N MARR RD
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City | COLUMBUS
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State | IN
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Zip | 47201-2609
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Country | US
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Telephone | 773-633-0874
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Fax |
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Provider Business Mailing Address
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Address Line | 1451 W THOME AVE
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City | CHICAGO
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State | IL
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Zip | 60660-1819
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Country | US
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Telephone | 773-633-0874
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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 | 05015103A
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License Number State | IN
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