Provider Demographics
NPI:1699264176
Name:HEMMINGSON, MELANIE (DPT)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:HEMMINGSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:HEMMINGSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1541 CENTENNIAL CT
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-7304
Mailing Address - Country:US
Mailing Address - Phone:307-235-3910
Mailing Address - Fax:307-266-2891
Practice Address - Street 1:1541 CENTENNIAL CT
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-7304
Practice Address - Country:US
Practice Address - Phone:072-353-9103
Practice Address - Fax:605-723-0186
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-09
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD2041225100000X
WY2052225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist