Provider Demographics
NPI:1104653484
Name:CATON, MELISSA RENEE (DPT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:RENEE
Last Name:CATON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 GOLDMILLER RD
Mailing Address - Street 2:
Mailing Address - City:BUNKER HILL
Mailing Address - State:WV
Mailing Address - Zip Code:25413-3497
Mailing Address - Country:US
Mailing Address - Phone:304-283-4362
Mailing Address - Fax:
Practice Address - Street 1:5047 GERRARDSTOWN RD STE 1A
Practice Address - Street 2:
Practice Address - City:INWOOD
Practice Address - State:WV
Practice Address - Zip Code:25428-3951
Practice Address - Country:US
Practice Address - Phone:304-821-1455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV002900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist