Provider Demographics
NPI:1962496398
Name:EBIG, MELISSA A (MS, ATC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:EBIG
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 EVERGREEN LN
Mailing Address - Street 2:
Mailing Address - City:CHESWICK
Mailing Address - State:PA
Mailing Address - Zip Code:15024-2244
Mailing Address - Country:US
Mailing Address - Phone:412-767-0169
Mailing Address - Fax:
Practice Address - Street 1:DUQUESNE UNIVERSITY
Practice Address - Street 2:600 FORBES AVE.
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15282-0001
Practice Address - Country:US
Practice Address - Phone:412-396-5491
Practice Address - Fax:412-396-5389
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART000960A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer