MEDICARE: MELANIE HEMMINGSON 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
1	225100000X	Physical Therapist	2041	SD
2	225100000X	Physical Therapist	2052	WY

General Provider Information

NPI Number	:	1699264176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE HEMMINGSON DPT

Provider Business Mailing Address
First Line	:	1541 CENTENNIAL CT
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82609-7304
Country	:	US
Telephone Number	:	307-235-3910
Fax Number	:	307-266-2891

Provider Business Practice Location Address
First Line	:	1541 CENTENNIAL CT
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82609-7304
Country	:	US
Telephone Number	:	72-353-9103
Fax Number	:	605-723-0186

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

Provider Enumeration Date	:	05/09/2018
Last Update Date	:	10/31/2022

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Directions to “ MELANIE HEMMINGSON DPT” Practice Location

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