MEDICARE: MELISSA HUBBARD PT

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	225100000X	Physical Therapist	05007978A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447377809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA HUBBARD PT

Provider Business Mailing Address
First Line	:	3866 STONEMEADOW DR
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46142-9440
Country	:	US
Telephone Number	:	317-341-1479
Fax Number	:	317-791-9001

Provider Business Practice Location Address
First Line	:	6239 S EAST ST STE A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-2088
Country	:	US
Telephone Number	:	317-791-9031
Fax Number	:	317-791-9001

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

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	09/17/2019

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Directions to “ MELISSA HUBBARD PT” Practice Location

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