Provider Demographics
NPI:1174334874
Name:COWLEY, MELISSA SUE (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:SUE
Last Name:COWLEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 W WINDEMERE AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-2418
Mailing Address - Country:US
Mailing Address - Phone:425-263-2217
Mailing Address - Fax:
Practice Address - Street 1:2448 FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48302-0335
Practice Address - Country:US
Practice Address - Phone:248-850-7008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501303721APP24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist