MEDICARE: MELANIE GARRETT REEDE PTA

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	225200000X	Physical Therapy Assistant	1021	NC

General Provider Information

NPI Number	:	1356650220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE GARRETT REEDE PTA

Provider Business Mailing Address
First Line	:	5213 PALMETTO LN
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-4136
Country	:	US
Telephone Number	:	910-425-7420
Fax Number	:

Provider Business Practice Location Address
First Line	:	5213 PALMETTO LN
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-4136
Country	:	US
Telephone Number	:	910-425-7420
Fax Number	:

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

Provider Enumeration Date	:	09/27/2010
Last Update Date	:	09/27/2010

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