Melinda Dickerson, PT, DPT

Individual provider Active NPI Physical Therapist · Amory, MS

NPI 1114394095 · NPPES record last updated Aug 27, 2015

Key facts

NPI
1114394095
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT973 (MS)
Practice address
404 Peg LN
Amory, MS 38821-1210
Phone
(662) 315-0084
Fax
(479) 709-7717
NPI assigned
Aug 27, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT973MSMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT973 MS Yes

Addresses

Primary practice location

404 Peg LN
Amory, MS 38821-1210

Mailing address

404 Peg LN
Amory, MS 38821-1210
Phone (662) 315-0084

Other providers in Amory, MS

All providers in Amory, MS · Physical Therapist in Mississippi

Sources for this page

Verify at the official NPI Registry.