Provider Demographics
NPI:1588734792
Name:CARLONE, MELANIE RITA (DPT)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:RITA
Last Name:CARLONE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:CARLONE
Other - Last Name:KILMARX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:784 NANTUCKET AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-2719
Mailing Address - Country:US
Mailing Address - Phone:541-790-2092
Mailing Address - Fax:541-636-5352
Practice Address - Street 1:784 NANTUCKET AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-2719
Practice Address - Country:US
Practice Address - Phone:541-790-2092
Practice Address - Fax:541-636-5352
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR06505OtherOREGON STATE LICENSE
GAPT004233OtherLICENSE#