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NPI Code Detail

MEDICARE: MELISSA JANE WESTON DPT

MEDICARE: MELISSA JANE WESTON DPT
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
1225100000XPhysical TherapistPT012786OH

General Provider Information

NPI Number : 1164887139
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA JANE WESTON DPT
Provider Business Mailing Address
First Line : 625 ENTERPRISE DR
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-8813
Country : US
Telephone Number : 630-575-6200
Fax Number : 630-928-5080
Provider Business Practice Location Address
First Line : 476 FORTMAN DR
Second Line :
City : SAINT MARYS
State : OH
Zip : 45885-1870
Country : US
Telephone Number : 419-300-8400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2015
Last Update Date : 07/28/2017

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