Provider Demographics
NPI:1851320428
Name:SMITH, MELISSA ANN (MS, ATC)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:ARROWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, ATC, SCAT, LAT
Mailing Address - Street 1:137 HALLING DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-6525
Mailing Address - Country:US
Mailing Address - Phone:803-800-4494
Mailing Address - Fax:
Practice Address - Street 1:438 KILLIAN AVE RM 101
Practice Address - Street 2:
Practice Address - City:SHAW AFB
Practice Address - State:SC
Practice Address - Zip Code:29152-5046
Practice Address - Country:US
Practice Address - Phone:803-895-1867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5582255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer