Provider Demographics
NPI:1679082739
Name:MELNICK, CATHERINE D (PTA)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:D
Last Name:MELNICK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 BLUE FIELD LN
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29936-7069
Mailing Address - Country:US
Mailing Address - Phone:843-338-9656
Mailing Address - Fax:
Practice Address - Street 1:60 MAIN ST UNIT G
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-6603
Practice Address - Country:US
Practice Address - Phone:843-683-6136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3797225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant