Provider Demographics
NPI:1154537173
Name:WILLIAMS, MELISSA POPE (MSPT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:POPE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 SOUTH CHERRY ST. STE. 640
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033
Mailing Address - Country:US
Mailing Address - Phone:303-333-3493
Mailing Address - Fax:
Practice Address - Street 1:901 ENGLEWOOD PKWY
Practice Address - Street 2:SUITE #108
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-2305
Practice Address - Country:US
Practice Address - Phone:303-761-3085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8637225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCO304604Medicare PIN