Melton Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501009879 Issued in MI

Legal business name

MELTON PHYSICAL THERAPY

Practice address

1050 S Otsego Ave
Gaylord, MI 49735-9171

Phone

(989) 731-6781

Fax

(989) 705-8448

NPI assigned

Oct 10, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mark R Melton, PHYSICAL THERAPIST

Title

President/Owner

Phone

(231) 258-6789

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1306034772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 S OTSEGO AVE",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497359171",
            "telephone_number": "989-731-6781",
            "fax_number": "989-705-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 S OTSEGO AVE",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497359171",
            "telephone_number": "989-731-6781",
            "fax_number": "989-705-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELTON PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "MELTON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "231-258-6789",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501009879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meijer Inc
• Melanie Hunt, LLC
• Danielle Melching, B.A.A
• Shannon Mellema
• Antonios Mello, CADC-DP
• Mark Richard Melton, P.T.
• Matthew James Mercer, RBT
• Renee Deanne Mesack, P.A.-C
• Michael J. Cusatis DDS PLLC
• Mila Incorporated

• Physical Therapist in Gaylord, MI
• Providers in Gaylord, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.