Stavrakis, Melissa Jane

Stavrakis, Melissa Jane is an individual health care provider with primary practice located at 1605 Grand Central Ave , Vienna WV 26105-1081. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Stavrakis, Melissa Jane can be contacted via phone (304) 295-7290.

Contact Information

Primary practice address
1605 Grand Central Ave Vienna WV 26105-1081
Phone: (304) 295-7290
Fax: (304) 295-5922
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 002359 West Virginia

Profile Details

NPI number 1780690859
LBN Legal business name Stavrakis, Melissa Jane
Credentials DPT, OCS
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated May 24th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780690859 NPPES
West Virginia MEDICAID 7301143000
West Virginia Other P00148738
West Virginia MEDICAID 2590290

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