Provider Demographics
NPI:1962028191
Name:CARY, MELINDA (MPT)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:CARY
Suffix:
Gender:
Credentials:MPT
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:
Other - Last Name:DUCKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:PO BOX 252
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS CITY
Mailing Address - State:CA
Mailing Address - Zip Code:96024-0252
Mailing Address - Country:US
Mailing Address - Phone:907-521-0468
Mailing Address - Fax:
Practice Address - Street 1:60 EASTER AVE
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:CA
Practice Address - Zip Code:96093-8054
Practice Address - Country:US
Practice Address - Phone:907-521-0468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-23
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPHYP1144225100000X
CAPT306187225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist