Provider Demographics
NPI:1285066811
Name:WEISENSTEIN, MELISSA ODEAL (PT, DPT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ODEAL
Last Name:WEISENSTEIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 LEXINGTON DR
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-3733
Mailing Address - Country:US
Mailing Address - Phone:724-614-0703
Mailing Address - Fax:
Practice Address - Street 1:226 LEXINGTON DR
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-3733
Practice Address - Country:US
Practice Address - Phone:724-614-0703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0228532251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics