Provider Demographics
NPI:1588490973
Name:FUEMMELER MELLOY, HELEN ALEXIS
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:ALEXIS
Last Name:FUEMMELER MELLOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14302 E 97TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64139-1127
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:92 MO-58
Practice Address - Street 2:
Practice Address - City:CENTERVIEW
Practice Address - State:MO
Practice Address - Zip Code:64019
Practice Address - Country:US
Practice Address - Phone:660-656-3316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013028597225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist