Doctor Name: | MELVIA D. MIMS |
NPI Number: | 1174755425 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | PT24928 |
Business Practice Address: | 931 Us Highway 331 S Unit H Defuniak Springs, FL - 324358720 |
Business Phone Number: | 8508927644 |
Business Fax Number: | 8508920420 |
Mailing Address: | 1153 Gulf Breeze Pkwy, GULF BREEZE |
State: | FL |
Postal Code: | 325617807 |
Phone Number: | 8509326382 |
Fax Number: | 8509325215 |
NPI Enumeration Date: | 08/20/2009 |
NPI Last Update Date: | 08/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT24928 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |