MEDICARE: MELISSA JOAN TURNER P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251P0200X	Pediatric Physical Therapist	3648	CO

General Provider Information

NPI Number	:	1104092147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA JOAN TURNER P.T.

Provider Business Mailing Address
First Line	:	22103 S WALNUT BLUFF RD
Second Line	:
City	:	PLEASANT HILL
State	:	MO
Zip	:	64080-9399
Country	:	US
Telephone Number	:	970-209-3188
Fax Number	:

Provider Business Practice Location Address
First Line	:	22103 S WALNUT BLUFF RD
Second Line	:
City	:	PLEASANT HILL
State	:	MO
Zip	:	64080-9399
Country	:	US
Telephone Number	:	970-209-3188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2008
Last Update Date	:	01/31/2020

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