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NPI Code Detail

MEDICARE: MELISSA R AIKSNORAS PT, DPT

MEDICARE: MELISSA R AIKSNORAS PT, 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 TherapistPT02197RI
2225100000XPhysical Therapist18512MA
3225100000XPhysical TherapistPT010748GA

General Provider Information

NPI Number : 1629214531
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA R AIKSNORAS PT, DPT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-238-7217
Fax Number :
Provider Business Practice Location Address
First Line : 5415 THOMPSON MILL RD
Second Line :
City : HOSCHTON
State : GA
Zip : 30548-4132
Country : US
Telephone Number : 709-653-5087
Fax Number : 770-965-3279
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2008
Last Update Date : 08/03/2020

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