MEDICARE: AMY LYNN MELTON 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	1135705	TX

General Provider Information

NPI Number	:	1982826160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY LYNN MELTON PT

Provider Business Mailing Address
First Line	:	11351 JAMES WATT DR
Second Line	:	STE. A
City	:	EL PASO
State	:	TX
Zip	:	79936-6627
Country	:	US
Telephone Number	:	915-217-8709
Fax Number	:

Provider Business Practice Location Address
First Line	:	11351 JAMES WATT DR
Second Line	:	STE. A
City	:	EL PASO
State	:	TX
Zip	:	79936-6627
Country	:	US
Telephone Number	:	915-849-6602
Fax Number	:	915-849-6603

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	09/24/2013

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