Melissa Wyatt
Individual provider Active NPI Physical Therapy Assistant · Annandale, MN
NPI 1275939019 · NPPES record last updated Nov 5, 2014
Key facts
- NPI
- 1275939019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- A792 (MN)
- Practice address
- 500 Park St E
Annandale, MN 55302-3060 - Phone
- (320) 274-3737
- NPI assigned
- Nov 5, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A792 | MN | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A792 | MN | Yes |
Addresses
Primary practice location
500 Park St E
Annandale, MN 55302-3060
Mailing address
500 Park St E
Annandale, MN 55302-3060
Other providers in Annandale, MN
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- Kathy Jane Vetter
- Jocelyn Willert
- Julie Mae Wymore
- Corey Zeig
- Sarah Zieska
- Zoe Lactation & Midwifery
All providers in Annandale, MN · Physical Therapy Assistant in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.