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NPI Code Detail

MEDICARE: MRS. MELANIE NUGENT MINTZ DPT

MEDICARE:  MRS. MELANIE NUGENT MINTZ  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 Therapist35951CA
2225100000XPhysical Therapist08468RLA

General Provider Information

NPI Number : 1568785822
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELANIE NUGENT MINTZ DPT
Provider Business Mailing Address
First Line : 6033 FLEETWOOD DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70817-3830
Country : US
Telephone Number : 979-220-5570
Fax Number :
Provider Business Practice Location Address
First Line : 6033 FLEETWOOD DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70817-3830
Country : US
Telephone Number : 979-220-5570
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2010
Last Update Date : 10/09/2012

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Directions to “ MRS. MELANIE NUGENT MINTZ DPT” Practice Location

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