| Doctor Name: | MR. CLEVELAND PAUL MELANCON |
| NPI Number: | 1205927209 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, OCS |
| License Number: | 01407 |
| Business Practice Address: | 17609 Old Jefferson Hwy Suite G Prairieville, LA - 707693979 |
| Business Phone Number: | 2256730200 |
| Business Fax Number: | 2256730202 |
| Mailing Address: | 17609 Old Jefferson Hwy, Suite G PRAIRIEVILLE |
| State: | LA |
| Postal Code: | 707693979 |
| Phone Number: | 2256730200 |
| Fax Number: | 2256730202 |
| NPI Enumeration Date: | 09/27/2006 |
| NPI Last Update Date: | 03/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 01407 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |