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General NPI Number Information
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NPI Number | 1699347781
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Entity Type | Individual
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Provider Name | MELISSA A WIOREK DPT
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Gender | Female
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Dates
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Enumeration Date | 07/16/2021
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 10215 FERNWOOD RD STE 303
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City | BETHESDA
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State | MD
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Zip | 20817-1183
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Country | US
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Telephone | 301-530-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 5918 CURRANT LN
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City | GREENDALE
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State | WI
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Zip | 53129-2427
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Country | US
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Telephone | 414-630-1005
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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 | 15410-24
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License Number State | WI
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