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General NPI Number Information
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NPI Number | 1922524693
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Entity Type | Individual
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Provider Name | MELISSA LAI LI DPT
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Gender | Female
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Dates
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Enumeration Date | 08/15/2017
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 3975 OLD REDWOOD HWY MEDICAL OFFICE BUILDING 5, SUITE 152
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City | SANTA ROSA
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State | CA
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Zip | 95403-1719
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Country | US
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Telephone | 707-566-5820
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Fax |
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Provider Business Mailing Address
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Address Line | 504 MALLORY AVE
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City | WINDSOR
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State | CA
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Zip | 95492-8884
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Country | US
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Telephone | 707-228-6892
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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 | 293377
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License Number State | CA
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