Doctor Name: | MS. LISA A MELLOW |
NPI Number: | 1043269582 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. |
License Number: | PT00687 |
Business Practice Address: | 1524 Atwood Ave Dba/robert Buonanno Johnston, RI - 029193228 |
Business Phone Number: | 4013516200 |
Business Fax Number: | 4013516201 |
Mailing Address: | 1524 Atwood Ave, Dba/robert Buonanno JOHNSTON |
State: | RI |
Postal Code: | 029193228 |
Phone Number: | 4013516200 |
Fax Number: | 4013516201 |
NPI Enumeration Date: | 05/10/2006 |
NPI Last Update Date: | 04/08/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT00687 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | RI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |