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General NPI Number Information
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NPI Number | 1770615163
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Entity Type | Individual
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Provider Name | MELISSA MARIE WINZEK PT
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Gender | Female
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 2300 GALLBERRY LN
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City | WAXHAW
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State | NC
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Zip | 28173-0161
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Country | US
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Telephone | 704-243-3584
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Fax | 704-843-9045
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Provider Business Mailing Address
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Address Line | 18541 VICTORIA BAY DR
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City | CORNELIUS
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State | NC
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Zip | 28031-5542
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Country | US
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Telephone | 412-506-0659
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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 | PT010097L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | PT010097L
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License Number State | PA
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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 | P20189
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License Number State | NC
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