Basic Information
| Provider Information | |||||||||
| NPI: | 1306882733 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CROUSE | ||||||||
| FirstName: | MELISSA | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16600 W SPRAGUE RD | ||||||||
| Address2: | |||||||||
| City: | MIDDLEBURG HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441306318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2162277700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10204 GRANGER RD | ||||||||
| Address2: | |||||||||
| City: | GARFIELD HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441253106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2165812900 | ||||||||
| FaxNumber: | 2165814505 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2006 | ||||||||
| LastUpdateDate: | 12/27/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 014700 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.