MEDICARE: MELISSA J PATTON 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	3541	SC

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	:	1558314187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA J PATTON PT

Provider Business Mailing Address
First Line	:	2586 HIGHWAY 17 SOUTH
Second Line	:	UNIT C & D
City	:	GARDEN CITY BEACH
State	:	SC
Zip	:	29576-6605
Country	:	US
Telephone Number	:	843-651-6565
Fax Number	:	843-651-6575

Provider Business Practice Location Address
First Line	:	2586 HIGHWAY 17 BUSINESS SOUTH
Second Line	:	UNIT C & D
City	:	GARDEN CITY BEACH
State	:	SC
Zip	:	29576-6605
Country	:	US
Telephone Number	:	843-651-6565
Fax Number	:	843-651-6575

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	10/14/2011

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