Myrtle Decker, PT
Individual provider Active NPI Physical Therapist · W Melbourne, FL
NPI 1598879355 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1598879355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT7631 (FL)
- Practice address
- 2129 W New Haven Ave
W Melbourne, FL 32904 - Phone
- (321) 724-0060
- Fax
- (321) 724-6775
- NPI assigned
- Aug 18, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT7631 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| One to One Rehab Strength and Wellness LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT7631 | FL | Yes |
Addresses
Primary practice location
2129 W New Haven Ave
W Melbourne, FL 32904
Mailing address
1043 Tortoise Cove
Melbourne, FL 32935
Phone (321) 480-4858
Other providers in W Melbourne, FL
- Care Chiropractic & Wellness Center, Inc.
- Keisha Carter
- Lori Childers
- Coley Chiropractic PA
- Amy Dascanio
- Sharon Dunn
- Express Eyeglass Venture LLC
- Eye Centers of Brevard, LLC
- Amy B Faulkner
- Florida Pediatric Group PA
All providers in W Melbourne, FL · Physical Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.