Provider Demographics
NPI:1295781672
Name:AHO, MELISSA JOAN (MSPT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:JOAN
Last Name:AHO
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:JOAN
Other - Last Name:BARNHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 PINE HILL DR SW
Mailing Address - Street 2:
Mailing Address - City:MC DONALD
Mailing Address - State:TN
Mailing Address - Zip Code:37353-5622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:350 PINE HILL DR SW
Practice Address - Street 2:
Practice Address - City:MC DONALD
Practice Address - State:TN
Practice Address - Zip Code:37353-5622
Practice Address - Country:US
Practice Address - Phone:423-991-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0446652Medicaid
TN5441444Medicaid
TN3156797OtherBCBST - GROUP NUMBER
TN5441444Medicaid