Basic Information
| Provider Information | |||||||||
| NPI: | 1275879264 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SALLING | ||||||||
| FirstName: | MELANIE | ||||||||
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| OtherLastName: | SLOAN | ||||||||
| OtherFirstName: | MELANIE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1910 N CHURCH ST | ||||||||
| Address2: | STE D | ||||||||
| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274055666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3362747480 | ||||||||
| FaxNumber: | 3362748903 | ||||||||
| Practice Location | |||||||||
| Address1: | 2828 MAPLEWOOD AVE | ||||||||
| Address2: | STE A | ||||||||
| City: | WINSTON SALEM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 271034138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3367654703 | ||||||||
| FaxNumber: | 3367651396 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2012 | ||||||||
| LastUpdateDate: | 12/18/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | A2533 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.